Employer's Report of Injury or Occupational Disease

WorkSafeBC account: BRITISH COLUMBIA RAPID TRANSIT COMPANY LTD. (#333926)

Date & time submitted: 2/3/2026 10:13:50 AM
Source: Portal

Report type:

An occupational disease

r— Operating Location

Operating location number:
Operating location description:
Operating location address:

6800 14TH AVE BURNABY BC V3N 4S7

001
OMC

r~ Classification Unit

Classification unit number:
Classification unit description:

Comm Bus, Shuttle, or Public Transit nes

732046

~ Employer Contact
Last name:
First name:
Phone number:
Fax number:

PRIER
CONNIE
(604) 653-8439 Ext:

r— Payroll Contact

Last name:
First name:
Phone number:
Fax number:

JINAHBAI
ARTI
(672) 335-4657 Ext:

r~ Worker Details
Last name: HOLAND
Middle initial:
First name: MARK
Gender:
Date of birth: 1978/09/04
Social insurance number: 730742368
Claim number (if known): 42647461
r—- Worker Address
Country: Canada
Mailing address UNIT 311 318 AGNES ST
City: NEW WESTMINSTER
Province: British Columbia
Postal code: V3L 0J3
r~ Worker Contact Information
Home phone number:
Work number: Ext:

r— Worker Employment Details

What's the worker's occupation?
Did the worker's injury occur while performing

Relief Control Operator

volunteer activities? NO

Did the worker deduct business or equipment

expenses from the employment income? NO

Is the worker a relative of an employer? NO
r— Incident Details

Occupational Disease Exposure Dates:

Exposure start date: 2026/01/12

Exposure end date: 2026/01/25
r~ Reported to Employer

Did the worker report the injury/exposure to the

employer? YES

Date reported to employer: 2026/01/25