Injury Line: Tri-State Pole & Piling, Inc.
| Inspection Nr | 496178.015 |
| Investigation Nr | 20575.015 |
| Line Nr | 1 |
| Age | 15 |
| Sex | M |
| Nature of Injury |   |
| Part of Body |   |
| Source of Injury |   |
| Event Type | Struck By |
| Environmental Factor |   |
| Human Factor |   |
| Occupation | Technicians, n.e.c. |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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