Injury Line: C.L. Peck/Jones Brothers Construction Corporation
| Inspection Nr | 106147523 |
| Investigation Nr | 14471510 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Other |
| Part of Body | Bodysystem |
| Source of Injury | Hoisting Apparatus |
| Event Type | Fall(From Elevation) |
| Environmental Factor | Materials Handlg Equip./Method |
| Human Factor | Mater-Handlg Proced. Inappropr |
| Occupation | Carpenters |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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