NYC 9/11 Public Portal Document
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PERSONNEL ROSTER page
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1. Client: 12. Project Name 3. Project Address: 4. Project Number:
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5. Abatement Contractor: 6. Abatement Contractor Foreman: 47. ATC Representative: 8. Starting Date:
9. 10. 11_ 12. CERTIFICATE 13. 14. 15. DATE
CAPACITY SOCIAL SECURITY RESPIRATOR
NAME ADDRESS A. B. NUMBER TYPE
Agency Number MONTH. 1 YEAR: '
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KEY: H: Asbestos Handler 1. Half face Air Purifying Respirator w/HEPA NOTE:
S: Asbestos Supervisor 2. Full face Air Purifying Respirator w/HEPA
A: NYC 3. Powered Air Purifying Respirator w/HEPA
8: NYS 4. Type C. Supplied Air Respirator (SAR) w/HEPA
C: Other 5. Type C. SAR w/SCBA
SPECIFY
NY.d IfVOQI
NYC-WTC 000129720
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