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← Document results/GRM 011339086 - BOX 13/IAQ REFERRALS TO EPA
Document / 19 pages

DEP IAQ Referral Form to EPA, Apr 2002

Machine-extracted title · confidence 85%

Referral form noting health concerns related to air monitoring results at a specific location.

NYC-WTC_000147722–000147740

Folder label: “IAQ REFERRALS TO EPA”

Page image
Scanned page image, NYC-WTC_000147738
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Date: Tom: Name of Operator

e go : (circle on Cleanin Health Indoor Air Environment ool Old WTC Other — Specific Contaminant

Comments -

Collar in o17IIAt1011: _,._._._.i_._._._._._._ P11 Last Name: 1-- PH - __._._.. ._._._ First Name- —

Address 1 7 . 8r7 Apt— ._ P.I. I ._.I Borough: Address 2:

City _ _ _ ... _._. ---t- erS :._._._. Zip:

Phone #1 PII - -------------------------- -• Phone #2 (_i

Follow ua• YES NO ReferrallFollow-Up Needed? (circle%

Referral Agency/Organization: .C/' DEP Reference #

NYC-WTC 000147738

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

NYC-WTC_000147738Source: NYC Law Department, mirrored locally

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