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← Document results/DEP Box 09/DEP REFERRALS/F4 Entered in Database (1-2)
Document / 3 pages

DEP referral form with ID NYC-WTC_000146897, Sept 2001

Machine-extracted title · confidence 100%

Referral form page containing handwritten entries and the unique identification number NYC-WTC_000146897.

NYC-WTC_000146896–000146898

Folder label: “DEP REFERRALS/F4 Entered in Database (1-2)”

Page image
Scanned page image, NYC-WTC_000146897
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

•■>. *- •

Name of Operator Date: ^/n //i^ Category; (circle one)

Environntent Cleaning Health Indoor Air

Specific Contaminant School OldWTC Other

y— - IUTT . TT

zlZ/ 6u/"

Caller Ipforroatlon;

First Name: Xastmme:

Address 1: Apt!-

Address 2:_______ _______________________ BoriiL.Bh:

City State: Zip:

Phone #1( Pll Phone #2 () I

Follow up; I

Referral/Follow-Up Needed? (circle one) YES NO

Referral Agency/Organization; h DEP Reference #

NYC-WTC_000146897

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NYC-WTC_000146897Source: NYC Law Department, mirrored locally

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