NYC 9/11 Public Portal Document
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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
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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
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000147908Source: NYC Law Department, mirrored locally