NYC 9/11 Public Portal Document
Regulatory Submittal Part III — Health & Safety Plan
Fiterman Hall — 30 West Broadway, New York, New York
Airtek Project 05-0867 — January l0, 2006
FIGURE 1.1 IPAGE I OF
ACCIDENT-EXPt)SURE IN'V'ESTIGATION REPORT
COMPANY DATE
I.vrsrIcAnoN TEAN9
Eru'LGYErS NA1ts & ID
SFx JUB DESCRIPITQN
DEP.ARTLENT & LoCATI)N
ACCIDENT DATE & T41IE
DATE & TL%tE-aICCIDE.IT REPOIrED TO SUPERVISOR
NATURE M INCIDENT
NATURE OF INIL'RT
RII ERRED TO MIEAIcALFACIIhrv1 ()CTOR ❑ YES ❑ No
EMPLOYEE RETL'RNrDTO WORK ❑ YES DAnuTLbIE ❑ No
❑ INIuiED E1iPI.{IEEE. L\"fER[1aw STATESlI N'r - .~TrACIIED
WITNESSES
❑ 44rrNsssEsINTERVIEWS./STATEME:N'TS • iTACnnED
❑ RIOTCX;RAPt1S OF SITE - Ar r, chap
❑ DIAGRAMS OF SITE - ATTACHLD
FQUIPMENTRECORDS- ATTAU D- RF1TL itn ❑ YES ❑ Na
ACCmrNT.--EXPosvluI INCIDENT DEscRQ'TIoN
l9
NYC-WTC 000095799
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