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← Document results/GRM 011339086 - BOX 13/DEP REFERRALS/F4 Entered in Database (1-2)
Document / 3 pages

DEP referral intake form with handwritten notes and follow-up

Machine-extracted title · confidence 90%

Handwritten DEP referral form documenting operator information, school category, address, contact details, and follow-up status.

NYC-WTC_000146954–000146956

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

Page image
Scanned page image, NYC-WTC_000146954
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

f3 M

Name of Operator Date: Time• 3 ~~! Ca o : (circle on

Environment Cleaning H

Specific Contaminant School

ues on: 1. _ //_ _ i _,

Comments:

First Name: Last Name:

Address 1:

Address 2:

City State: Zip:

Phone # P II Phone #2 ( )

Follow up: t 6 1 Referral/Follow-Up Needed? (circle one) YES NO

Referral Agency/Organization:

DEP Reference # 4"27 /i'o

,172 17 "i'~: d NYC-WTC 000146954

OCR can misread numbers and units. Confirm readings against the page image before using them.

NYC-WTC_000146954Source: NYC Law Department, mirrored locally

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