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

DEP Cleaning or Health Referral Form, Old WTC Site

Machine-extracted title · confidence 90%

DEP referral form with selections for cleaning or health categories regarding an issue at the Old World Trade Center.

NYC-WTC_000147102–000147103

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

Page image
Scanned page image, NYC-WTC_000147102
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

c T) Name of Operator ~ r Date: Tins;:

t o : (circle one) Cleaning Health Indoor Air nment School Old WTC Other _ Specific Contaminant

t/07'C8WO1"

First Name: ___ P11 Last Nom: - _._._._._._._._._._._._._._._._._._._._._._._._._

Addressis PI1 Apt Borough: Address 2: State_ _ ZiP city P11 Phone #l~.-._._._._._._._._._._._._. ._ Phone #2L P"1

Followun

Referral/Follow-UP Needed? (circle one) (j) NO 1 wt-'C H

Referral Agency/Organization: u _! pi e

3 DEP Reference #

NYC-WTC 000147102

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

NYC-WTC_000147102Source: NYC Law Department, mirrored locally

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