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← Document results/GRM 011339086 - BOX 13/DEP REFERRALS/F4 Entered in Database (1-2)
Document / 4 pages

DEP Health or Cleaning Referral Form, WTC Site

Machine-extracted title · confidence 90%

Form documenting health or cleaning referrals for the World Trade Center site with follow-up status.

NYC-WTC_000147052–000147055

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

Page image
Scanned page image, NYC-WTC_000147052
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Name of Operator Date: Time: Z .

Category: (circle one)

=Environment Cleaning Health Indoor Air

Specific Contaminant School Old WTC Other

•

Comments:

First Name:

Address 1:

Address 2: Borough:

City ~ _~_ State: Zip: I QAOl

Phone #1 P11 L Phone #2 (_)

- ©$ 2- Follow up: 31j„3-10 — I "I- Referral/Follow-Up Needed? (circle one) YES NO

Referral Agency/Organization: tL DEP Reference # T 5t i

NYC-WTC 000147052

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

NYC-WTC_000147052Source: NYC Law Department, mirrored locally

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