Injury Line: Larry Simon
| Inspection Nr | 312062995 |
| Investigation Nr | 201392594 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Multiple |
| Source of Injury | Materials Handlg Eq. |
| Event Type | Struck By |
| Environmental Factor | Illumination |
| Human Factor | Other |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task not regularly assigned |
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