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Indoor air quality referral form, operator submission

Machine-extracted title · confidence 90%

DEP indoor air quality referral form with operator-provided response to inquiry about environmental, WTC, or air quality concerns, including follow-up and referral fields.

NYC-WTC_000147836–000147837

Folder label: “IAQ REFERRALS TO EPA

Page image
Scanned page image, NYC-WTC_000147836
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

JVo 2 1^4 i Name of Operator y Date; Time:.

Category; (circle one) aeaning Health Indoor Air, It

School OWWTC Other Specific Contaminant

Question;

Answcr;

Comments;

CntlBr Information; Pll Pll Last Name; First Name;

Address 1; s?Y" Apt Borough: Address!: Stote: Zip: City__ , Phoned Pll Phone #2 (____ )

Follow up; Referfal/Follow-Up Needed? (circle one)

Referral Agency/Organization:

DEP Reference #

NYC-WTC_000147836

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

NYC-WTC_000147836Source: NYC Law Department, mirrored locally

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