ANDO'INTERNATIONAL INC.
861 Manhattan Ave., Suite 14, Brooklyn, NY 11222
Tel. (718) 349-6212
QUALITATIVE RESPIRATOR FIT TEST
This Respirator Fit Test is valid for the period of 12 (twelve) months from the date of test
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Test Provider . ANDO INTERNATIONAL INC. Test Agent:
Address: 861 Manhattan Ave., Brooklyn, NY 11222 1. Irritant Smoke
Telephone: (718) 349-6212 2. Odorous Vapor
Fax: (718) 349-3238 3. Taste Test
RESPIRATORS TESTED - SUCCESSFUL TEST
(Half Face Mask only)
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BRAND NAME: (t) (2) - SIZE: (I) I (2)
TEST DATE:
Name of person performing respirator fit test: 'A
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Fit test number: /' J .. Signature:
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NYC-WTC 000094992
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NYC-WTC_000094992Source: NYC Law Department, mirrored locally