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Tel: 212 • 965 - 1730
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MEDICAL EXAMINATION FOR RESPIRATORY PROTECTION
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DATE OF BIRTH
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BASED UPON THE MEDICAL WHICH INCLUDES:
1. PULMONARY FUNCTION TESTS (SPIROMETRY) OF FORCED VITAL CAPACITY (FVC), FORCED VITAL.
CAPACITY (FVC), FORCED EXPIRATORY VOLUME AT ONE SECOND (FEV l) AND INTERPRETATION.
2. A CHEST ROENTGENOGRAM, TWO (2) VIEWS AND RADIOLOGICAL. SERVICES PROVIDED BY A
QUALIFIED INTERPRETER
3. MEDICAL HISTORY
4. A PHYSICAL EXAMINATION DIRECTED TO THE PULMONARY AND GASTROINTESTINAL SYSTEMS
INCLUDING BUT NOT LIMITED TO HEIGHT, WEIGHT, BLOOD PRESSURE. PULSE AND RESPIRATION.
IT IS MY OPINION THAT THE ABOVE NAMED PATIENT IS OR IS NOT P$(YSICALLY QUALIFIED TO
WEAR A RESPIRATOR IN THE PERFORMANCE OF HIS/HER JOB:
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NYC-WTC 000120453
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000120453Source: NYC Law Department, mirrored locally
Technical report by Precision Testing & Balancing documenting the testing and balancing of existing supply air systems at the Mayor's Office of Emergency Management dated February…