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← Document results/GRM 011339086 - BOX 13/IAQ REFERRALS TO EPA
Document / 8 pages

DEP IAQ Referral Form to EPA, Apr 2002

Machine-extracted title · confidence 90%

Form recording an inquiry about air quality for a new resident and information on abatement costs.

NYC-WTC_000147801–000147808

Folder label: “IAQ REFERRALS TO EPA”

Page image
Scanned page image, NYC-WTC_000147804
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Name of Operator Q Date: t lime: /2k Q'S' '3

Category: (circle one)

Environment Cleaning Health Indoor Air

Specific Contaminant School Old WTC Other

dyi -

First Name: _,._._._._._._. P I I Last Name: l- - - - - - PII- - - - - -

Address 1: / ' 1 d x4. °`~ y ~ Apt

Address 2: /D ~`'/n% ~2~' Borough:

City /y State: MI' Zip: l U614

Phone #1 l PII Phone #2_._ PII

Follow up:

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

Referral Agency/Organization: It Il C7 '

DEP Reference #

NYC-WTC 000147804

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

NYC-WTC_000147804Source: NYC Law Department, mirrored locally

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