Injury Line: Stackhouse Inc Attn Myron Coon
| Inspection Nr | 2964294 |
| Investigation Nr | 14255616 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Bodysystem |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Flying Object Action |
| Human Factor | Safety Devices Removed/Inoper. |
| Occupation | Electrical power installers and repairers |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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