PREMISE NO o` STREET
S INSPECTION DATE
• t5 -
BORO CODE BLOCK WY SQUAD0 BADGEN
IR 1.'aAo~ _' I I I (0 3I I I I D ID
• 1s pR
NQ®
f tm P
i Lt & P' ;
BLDG TYPE BASIS OF INSPECT.-r ~' g , PHOTOS TAKEN YES I NO
t ~
1
CONTRACTORS NAME 0_ SAMPLE NO.
IL ~ t~ CITY SAMPLE NO
Rd O ~S A_%vf 1 AQ
STATE ZIP PHON SAMPLE NO
~30D
LABORATORY NAME OWNERS NAME
w .0 > ~£ ~ ~eE ~s P C_Eiis `iu2 .
ODOR CITY N `1 AD9R SrV CITY
14. S S
STATE t ZIP l y~O HO L „L_-
10 STATE'V M ZIP bO ,x y PHO E
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CONTACT PERSON: ~-, V r TIME OF INSPECTION FROM: O amlpm TO: 3 o amlpm
INSPECTION DISCLOSED:
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t
e's-o LJR.L) COQ
NOV a INFRACTIONS RESULT CODE
NOV r I
SUPS S INITIALS
BORO 1 - MANHATTAN 2 - BRONX 3 - BROOKLYN 4 - QUEENS 5 -RICHMOND
= BLDG TYPE A > 6 Stories 8 < a Stories C Single Family
D .School £ Hospital F Public Owned Property
RESULT CODES I - Violation Issued 2 - No Violations Issued 3 - No Access
a - Project not Started (No NOV) 5 - Project Completed (No NOV) ACP 30193
FILE
NYC-WTC 000122626
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000122626Source: NYC Law Department, mirrored locally
Invoice dated September 25, 2002, from Fiber Control Inc to the New York City Department of Environmental Protection for services at multiple job sites.