On July 8, 2008, a 25-year-old male volunteer fire fighter (the victim) was fatally injured after being ejected in a fire truck rollover. The crash occurred as the fire truck was returning to the station after a call for a propane gas fire. The fire truck was traveling down a winding, steep grade. The paved road had a posted speed limit of 45 mph with a curve warning sign and recommended safe speed of 20 mph through the S-curve. The driver lost control of the fire truck, swerved off the left side of the road, returned to the pavement and overturned on the right side of the road. The victim was not wearing a seat belt and was ejected out of the driver's side window. The pumper's 725 gallon water tank detached from the truck body and landed on top of the victim in the street. The victim was pinned underneath the water tank and died from injuries sustained in the crash. Key contributing factors identified in this investigation include: non-use of seatbelt, inadequate driver training, driver inexperience with this specific apparatus, an older apparatus with minimal safety features, potentially incorrect installation of a replacement water tank, and difficult road conditions. NIOSH investigators concluded that, to minimize the risk of similar occurrences, fire departments should: 1. ensure that standard operating procedures (SOPs) regarding seatbelt use are enforced; 2. provide and ensure all drivers successfully complete a comprehensive driver's training program [such as NFPA 1451, Standard for a Fire Service Vehicle Operations Training Program] before allowing a member to drive and operate a fire department vehicle; 3. ensure that replacement water tanks are installed according to manufacturer's instructions; 4. ensure that programs are in place to provide for the inspection, maintenance, testing and retirement of automotive fire apparatus; 5. consider replacing fire apparatus over 25 years old; 6. be aware of programs that provide assistance in obtaining alternative funding such as grant funding to replace or purchase fire apparatus and equipment. Additionally, federal and state departments of transportation should consider removing exemptions that allow fire fighters to not wear seat belts.