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Document / 3 pages

IAQ referral form, Old WTC site, Oct 2001

Machine-extracted title · confidence 85%

Completed intake sheet for an indoor air quality inquiry regarding the former World Trade Center site.

NYC-WTC_000147871–000147873

Folder label: “IAQ REFERRALS TO EPA

Page image
Scanned page image, NYC-WTC_000147873
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Name of Date:______

Category: (circle one)

Environment Cleaning Health Indoor Air

Specific Contaminant School OldWTC

z=?7;^-?-7z<-Zj

"z^ z^g^zj-y^

CpUer Informal----- pj-PH PH First Name: Last Name:

Address 1: rs2L> O / tx^X'C- Apt

Address!: J77 Borough:

State; City — “9" Phone ^rzv^ ,--------Pj j- ____________ j Phone #2^ Pll

Followup;

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

Referral Agency/Organization;

DEP Reference # 4^/ Z

NYC-WTC_000147873

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NYC-WTC_000147873Source: NYC Law Department, mirrored locally

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