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← Document results/DEP Box 09/IAQ REFERRALS TO EPA
Document / 2 pages

WTC Hotline intake form for EPA referrals

Machine-extracted title · confidence 100%

Blank form used by operators to record caller details and environmental concerns for EPA referrals.

NYC-WTC_000147747–000147748

Folder label: “IAQ REFERRALS TO EPA

Page image
Scanned page image, NYC-WTC_000147747
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Name of Operator Date:. _'Iime; /fir Category: (circle one)

Environment Cleaning Health Indoor Air =1^ Specific Contaminant School OldWTC Other

REaSoTS

z<^>77

Answer; z t < ■ yg :n^ — >___________ 5——

Coimnmte;

Caller Information:

Rist Name: I PH Last Name: PH ~ \ //

Address 1: &1_ apuLPH Address!;___________ Borough:

City State: Zip:

Phone #li Pll Phone #21 J

Follow up:

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

Referral Agency/Organization: _ .hff loau^^ih^ DEP Reference it JAM- —

NYC-WTC_000147747

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NYC-WTC_000147747Source: NYC Law Department, mirrored locally

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