Injury Line: Uebelhor & Sons Inc
| Inspection Nr | 311967467 |
| Investigation Nr | 200996916 |
| 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 | Materials Handlg Equip./Method |
| Human Factor | Lockout/Tagout Proced Malfunc |
| Occupation | Occupation not reported |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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