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

DEP environmental referral form, Old WTC category

Machine-extracted title · confidence 90%

Handwritten intake form with Old WTC category selection, operator name, and location/contact information fields.

NYC-WTC_000147100–000147101

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

Page image
Scanned page image, NYC-WTC_000147100
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

t4 4 x

/OJT- Time: 3303 Date: 1 Name of OperatorRJL~a~67~*,

Cattory: (circle one) Cleaning Health Indoor Air Environment School Old WTC Other Specific Contaminant

Oues % cQ L

/rkL M

Cots:

CalierInfora-"A mon• ._._._._._.. -.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-, II

First Name:; P11 ______ Last Names______________ - L✓ AptL P Address 1. Borough: - Address 2:

City State: Zip: P11 Phone #2 (_~ :::_._._._._._._..._._.-. Phone #f_ ._._. .-.-.- - - - - _ _

wit H Fo9WUP

Referral/Follow-UP Needed? (circle one) G) NO

Referral Agency/Organization: P 1 / 1)ô H DEP Reference # e-mw ci 9/,4_ cA rkd

NYC-WTC 000147100

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

NYC-WTC_000147100Source: NYC Law Department, mirrored locally

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