Injury Line: Foothill Engineering Co
| Inspection Nr | 112067764 |
| Investigation Nr | 170192983 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Amputation |
| Part of Body | Arm-Mult |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Struck By |
| Environmental Factor | Other |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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