On March 28, 2008, a 33-year-old male volunteer fire fighter (the victim) was fatally injured after the tanker truck he was driving left the roadway and overturned. The victim was enroute to a structure fire, took an unfamiliar route, and failed to negotiate a 90° curve to the right. The tanker left the roadway rolling onto the driver's side then slid through a ditch into a row of pine trees crushing the cab. The victim was extricated by emergency personnel, air-lifted to a local medical center, and later pronounced dead. NIOSH investigators concluded that, in order to minimize the risk of similar occurrences, fire departments should: 1. ensure that tankers are driven at a safe and reasonable speed; 2. ensure that fire fighters are familiar with the location of the roads in their coverage areas; 3. consider staffing tankers with a minimum of two fire fighters; 4. consider supplying responding units with maps or verbal directions to incident scenes, using computer aided dispatch (CAD) or a global positioning system (GPS) device; 5. develop oversight of the preventive maintenance program for fire apparatus. Fire departments and fire service training organizations should consider additional driver training for fire fighters on safe tanker driving and operations. Fire departments and fire apparatus manufacturers should ensure that tankers meet all the requirements of NFPA 1901, Standard for Automotive Fire Apparatus.