Injury Line: Long Brothers Roofing, Inc.
| Inspection Nr | 310328406 |
| Investigation Nr | 202077343 |
| Line Nr | 2 |
| Age | |
| Sex |   |
| Nature of Injury | Electric Shock |
| Part of Body | Back |
| Source of Injury | Elec Apparat/Wiring |
| Event Type | Shock |
| Environmental Factor | Work-Surface/Facil-Layout Cond |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Occupation not reported |
| Degree of Injury | Hospitalized injury |
| Task Assigned | Task regularly assigned |
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