NYC 9/11 Public Portal Document
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Name of Operator Date: Timer 36fp
Category: (circle one)
Environment (:Cleanin!g:) Health Indoor Air
Specific Contaminant Sc oo Old WTC Other (f2' ~
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Comments:
fi ller Informa~ton
First
Address 1: 2e4 'Ck
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Address 2: Borough:
City State• Zip: Ip2 v '
Phone #I. P11 _ Phone #2 ( )
Follow up:
Referral/Follow-Up Needed? (circle one) YE NO
Referral Agency/Organization:
DEP Reference # 7 ( "
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NYC-WTC 000146923
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