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August 7, 2003 (4:19pm)
DRAFT HOTLINE QUESTIONNAIRE
First Name:
Last Name:
Street Address:
Apartment Number:
Floor:
ZIP Code:
Cross Street #1:
Cross street #2
Mailing Address (if different):
Street/Box:
ZIP Code
Entry Information::
Telephone, Daytime:
Telephone, Evening:
Telephone, Fax:
email:
Confidentiality Code:
Number of rooms:
Central air conditioning:
Unit air conditioning (number and location of units):
Carpets (number, location and type):
Describe the dust situation when you first entered your apartment:
Light: Write in it: Measurable depth (estimate): Color:
Was your apartment first cleaned by:
Certified asbestos contractor (name): Approximate date:
Non-certified contractor: Approximate date:
Housekeeper: Approximate date:
Occupant: Approximate date:
If contractor, hired by building owner/manager or you:
Was your apartment tested before and/or after cleaning: Approximate date:
Do you know the results:
Were building common areas cleaned:
Do you want:
Your apartment professionally cleaned and tested for asbestos in air (after cleaning):
(This will take 2-3 days and will require you
or your representative to be present)
NYC-WTC_000138346
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000138346Source: NYC Law Department, mirrored locally
A project proposal outlining the timeline, methods, and justification for cleaning HVAC systems in residential units affected by World Trade Center dust.
A project proposal outlining the timeline, methods, and justification for cleaning HVAC systems in residential units affected by World Trade Center dust.