Injury Line: Colquitt Electric Membership Corp.
| Inspection Nr | 109007005 |
| Investigation Nr | 14343594 |
| Line Nr | 1 |
| Age | |
| Sex |   |
| Nature of Injury | Burn(Chemical) |
| Part of Body | Back |
| Source of Injury | Petroleum Products |
| Event Type | Rubbed/Abraded |
| Environmental Factor | Other |
| Human Factor | Misjudgment, Haz. Situation |
| Occupation | Supervisors; electricians & power transm. install. |
| Degree of Injury | Fatality |
| Task Assigned | Task regularly assigned |
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