Injury Line: Chuck Westenburg, Inc., Concrete Contractor
| Inspection Nr | 115588212 |
| Investigation Nr | 170064810 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Bodysystem |
| Source of Injury | Dirt/Sand/Stone |
| Event Type | Caught In Or Between |
| Environmental Factor | Other |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Concrete and terrazzo finishers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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