Illegible document excerpt with handwritten notes, 2002

NYC 9/11 Public Portal Document

K f3O Name of Operator w1Jt Date: 3 Time: 5:30 Category: (circle one)

Environment Cleaning Health

Specific Contaminant School Other

Q esti.9 _._._._._._._._.-_._._._._-- . _P1_I k h+ l ISSN - 3 M1di SMORMC f Ata d. W CQII i t4 I .I A1 — k6 k D~}

Answer:

Caller Information:

First Name: __ ._._._._ r I _ Last Name_ _ _ _ _ _ _ _ ______

Address 1• u b KGTDi 0.(:.A. Apt .. P11

Address

City Phone #1 vo" ' gl~~Iry ' n~ov —o Follow up: PIIR Referral/Follow-Up Needed? (circle one) ES NO

Referral Agency/Organization: / ____ -- 3%r/0.L DEP Reference # 4~ 1 C) o HJ W#5 5 3 7~`~

NYC-WTC 000143308