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ACCIDENT, INJURY AND ILLNESS INVESTIGATION <br /> I. DESCRIPTION <br /> Location/Address of Accident/Injury/Illness: <br /> Person(s)/Titles Conducting Investigation: <br /> Date and Time of Accident/Injury/Illness: <br /> Name(s)of Affected Employees: Part(s)of Body Affected: <br /> Nature of Accident/Injury/Illness: <br /> What Workplace Condition,Work Practice or Protective Equipment Contributed to the Accident? <br /> Was a Code of Safe Practice Violated? Yes No <br /> If Yes,Which One? <br />