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| Inspection Nr | 104829288 |
| Investigation Nr | 1005008 |
| Line Nr | 1 |
| Age | |
| Sex | |
| Nature of Injury | Dislocation |
| Part of Body | Shoulder |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Struck Against |
| Environmental Factor | Overhead Moving/Falling Obj Ac |
| Human Factor | Insuf/Lack/Protcv Wrk Clthg/Equip |
| Occupation | Miscellaneous material moving equipment operators |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task not regularly assigned |
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