NYC 9/11 Public Portal Document
Name of Operator. fh^vwLj'Hi; Date: X Time:
Category; (cirde one) --—
Cleaning Health Indoor Air y
Environment
School OldWTC Other___
Specific Contaminant
W> Hl- g.l.i»e. -----
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Caller Information; .1.
PH
First Name: '- y - ^.>^^,-0—^ ,.^---- - ----------------------------
Address 1: 358 OL gK^ ap<L_p»
Borough:
Address!:
stale: _!iyX Zip:
City
Phone #i ........ Pli......... Phone #2 (____ )
Follow up; BvrcH
Rfiferral/Follow-Up Needed? (circle one) YES NO
Referral Agency/Organization:
DEP Reference #
NYC-WTC_000146983
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