Injury Line: United Subcontractors, Inc. Dba G & G Insulation
| Inspection Nr | 308339993 |
| Investigation Nr | 200231652 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Chest |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Temperature +/- Tolerance Lev. |
| Human Factor | Equip. Inappropr For Operation |
| Occupation | Laborers, except construction |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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