Injury Line: Forby Contracting Inc
| Inspection Nr | 14896922 |
| Investigation Nr | 14445225 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Amputation |
| Part of Body | Othbodysys |
| Source of Injury | Motor Vehicle (Hwy) |
| Event Type | Struck By |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Position Inapropriate For Task |
| Occupation | Construction laborers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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