Injury Line: Potter Material Service Inc
| Inspection Nr | 14747166 |
| Investigation Nr | 731018 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Upper Arm |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Defective Equipment In Use |
| Occupation | Cementing and gluing machine operators |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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