Injury Line: Chatsworth Products Inc
| Inspection Nr | 315964916 |
| Investigation Nr | 200360048 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Fracture |
| Part of Body | Legs |
| Source of Injury | Motor Vehicle(Indus) |
| Event Type | Struck By |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Distracting Actions By Others |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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