Injury Line: Interstate Distrib Co
| Inspection Nr | 308080027 |
| Investigation Nr | 202364386 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Chest |
| Source of Injury | Other |
| Event Type | Other |
| Environmental Factor | Other |
| Human Factor | Other |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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