NYC 9/11 Public Portal Document
CTSI DAILY LO. {'ORM INSPECTION
Date: ,, ( C/ Ur I
Start Time: / J; 3 C) Finish Time: 7r ~ nC~
Technician (s) Name: ,'t`r l iv r t-;1 e' L-
. Technician's License Number: y'E, _/ S/ y'
Project #:
Project Client/Address: kl k491 S•/ •
Project Location/Area j7 e /'
Client Rep. (Signature): Client Project Manager:
Asbestos Contractor:_ ?I' ' a, /Z Supervisor:__P, 0&ry/Vr` . 6i1d 2_ b - ,Q/ C, ii-'
Project Scope of Work (i.e. Air Monitoring, Lead Sampling, Survey, IAQ, etc.):_ ItIf
Work Area Size: ACM Quantity Removed (specify LF or SF): 6C SF
Was the work area inspected by a regulatory agency/inspector (DOL, DEP, OSHA, DOH,
EPA, etc.): Yes or No
If yes, state the name, badge #, type of inspection & conversation.
NYC-WTC 000094998
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