Injury Line: Lucky Stores
| Inspection Nr | 111868725 |
| Investigation Nr | 170159388 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Burn/Scald(Heat) |
| Part of Body | Arm-Mult |
| Source of Injury | Fire/Smoke |
| Event Type | Other |
| Environmental Factor | Other |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Miscelaneous food preparation occupations |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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