Injury Line: Potter Electric Company
| Inspection Nr | 104671417 |
| Investigation Nr | 884692 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Bruise/Contus/Abras |
| Part of Body | Arm-Mult |
| Source of Injury | Hand Tool (Powered) |
| Event Type | Struck By |
| Environmental Factor | Flying Object Action |
| Human Factor | Distracting Actions By Others |
| Occupation | Concrete and terrazzo finishers |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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