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← Document results/DEP Box 09/DEP REFERRALS/F4 Entered in Database (1-2)
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DEP cleaning and health referral form, database entry

Machine-extracted title · confidence 90%

DEP intake form documenting cleaning and health-related referral with operator information, call details, and follow-up classification for database entry.

NYC-WTC_000147114–000147115

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

Page image
Scanned page image, NYC-WTC_000147114
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

k Name of Operator ^fVlCpra.U^'ffe Date: 3 hiF^d Time:

Category; (circle one)

Envi It Cleaniik^^ealth

Specific Contaminant

Questi^

vTauGjL— fV^ Crt^ (JbCr- cixtlCbfca czi<^ V^cpicl/j u:. ULclf-n,

CO Pitk.

AUi <Lb.f yv-tfa^O- ikfTKx H^4-IZH€ -h oLt<X>_______________________________________

Caller Information;

First Name: Pll Last Name:. Pll _____ JC__ /T\___ ft..J(^..

Address 1 Pll u } Apt Pll Address 2:

City State: Zip:

Phone #]^ PU Phone #2 (, .) 11 pkewe] Follow up;

Referral/Follow-Up Needed? (circle one) YES NO

Referral Agency/Organization:

hr ■

NYC-WTC_000147114

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NYC-WTC_000147114Source: NYC Law Department, mirrored locally

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