Injury Line: Winston Tire Co.
| Inspection Nr | 112213632 |
| Investigation Nr | 170155360 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Wrist(S) |
| Source of Injury | Dust/Particles/Chips |
| Event Type | Card-Vasc/Resp Fail. |
| Environmental Factor | Weather, Earthquake, Etc. |
| Human Factor | Lockout/Tagout Proced Malfunc |
| Occupation | Occupation not reported |
| Degree of Injury | Non Hospitalized injury |
| Task Assigned | Task regularly assigned |
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