Injury Line: Custom Concrete, Ltd.
| Inspection Nr | 126621580 |
| Investigation Nr | 897785 |
| Line Nr | 3 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Multiple |
| Source of Injury | Materials Handlg Eq. |
| Event Type | Caught In Or Between |
| Environmental Factor | Other |
| Human Factor | Other |
| Occupation | Supervisors, material moving equipment operators |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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