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Document / 3 pages

IAQ referral form for commercial asbestos testing request, March 2002

Machine-extracted title · confidence 85%

Document logging a request for asbestos testing in a commercial building following WTC events.

NYC-WTC_000147906–000147908

Folder label: “IAQ REFERRALS TO EPA

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Scanned page image, NYC-WTC_000147908
OCR text

OCR status: ocr · source: ours

NYC 9/11 Public Portal Document 4) . ’ . poe ™, Name of Operator oe ne P| ae Date: </ 30 __ Time: ba Ae Category: (circle one) 2 YN Environment Cleaning >) Health Indoor Air Specific Contaminant “School Old WTC NA ali : dot forl mee Che go ma — adusec! calle tee CLP EPA. 4O Wis FAs ae oT First Name: | Pll Last Name: ! rateow 1: WG Street oT) Address 2: - Borough: City INL YO, at State: LIT a p: OOS’ Phone a P l ! = Phone #2 ( ) Follow un: Referral/Follow-Up Needed? (circle one) cfs NO Referral Agency/Organization: ; DEP Reference # NYC-WTC_000147908

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NYC-WTC_000147908Source: NYC Law Department, mirrored locally

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