Injury Line: Van Smith Concrete Company
| Inspection Nr | 309056240 |
| Investigation Nr | 200373876 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Multiple |
| Source of Injury | Working Surface |
| Event Type | Rep. Motion/Presure |
| Environmental Factor | Materials Handlg Equip./Method |
| Human Factor | Lockout/Tagout Proced Malfunc |
| Occupation | Helpers, mechanics and repairers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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