NYC 9/11 Public Portal Document
Name of Operator Date: Time: j Q ,J, pg,
Category: (circle one)
E vironment Cleaning
( ) Health
Specific Contaminant School Other
Question: 7 2 --ti
61 I ?A -4
Answer: i-2 -- fcA7
____
( )7 -
"7 jfrA
L 2' -'4493 /"e)
Caller Inform_ _a_ ti_o_n_ : -------------------------------------------- - ,~'~`J
First Name: L P Last Name: H
-------------------------------
Address 1: ~/l ~N ~T= Apt P HH -
Address 2:
City State: Zip:
--------------------------------------------.- ... .-.-.-.-.-.-.-.-.-.-ti
Phone # 11_,_._._._._._. _._._._._._._._._. P _._._.. Phone #2 ( )
Follow up: 1
Referral/Follow-Up Needed? (circle one) YES NO
/
Referral Agency/Organization:
DEP Reference #
5>re 4 lr laa~ C& eGi~
fL
z1-w
NYC-WTC 000147886
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