Injury Line: D. W. Burt Concrete Construction Incorporation
| Inspection Nr | 2822534 |
| Investigation Nr | 14198212 |
| Line Nr | 3 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Bodysystem |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Other |
| Environmental Factor | Materials Handlg Equip./Method |
| Human Factor | Position Inapropriate For Task |
| Occupation | Concrete and terrazzo finishers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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