NYC 9/11 Public Portal Document
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•sSOC OTIS INC.
ABATEMENT CONTRACTOR
PERSONNEL ROSTER Page of
1. Client: 2. Project Name 3. Project Address: 4. Project Number
5. Abatement Contractor: 6. Abatement Contractor Foreman: = 7. ATC Representative: 8. Starting Date:
g. 1o( 11. 12. CERTIFICATE 13. 14. 15. DATE
SOCIAL SECURITY RESPIRATOR
NAME . ADDRE S CAPACITY B. NUMBER TYPE
tii ' A• Agency Number MONTH: 1 YEAR. T
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KEY: H: Asbestos Handler . 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
B: NYS 4. Type C. Supplied Air Respirator (SAR) w/HEPA
C: Other 5. Type C. SAR w/SCBA
SPECIFY
NY -4 l' .QQ
NYC-WTC 000129722
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