NYC 9/11 Public Portal Document
Name of Operator /'I Date: _ Time:
Category• ('irc1e one)
•••..onment , Cleaning Health
Spe..ific Contaminant :ehool 4c4 O r
Question: ) y~
/ 1) L
• 1
Answer:
p.
-rn - )6 1 c
Comments:
tç j' k .N'"i-5 4P'iT -/e J)L i '--
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Caller II
PII Last Name:
/ C'~/1'/;
Address 1: , 7` 5 PII
Apt .-.-.-.-.-.-.-.-.
Address 2:
City State: Zip:
Phone #1; PII Phone #2 ( )
Follow up:
Referral/Follow-Up Needed? (circle one) rYES } NO
Referral Agency/Organization: I / /,SJ, tO
DEP Reference # 2$D f
3 iS1na -Ctz i PII r . ~~,
t# -Jut cA Ut Uw C
NYC-WTC 000147931
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