NYC 9/11 Public Portal Document
*’^**DRAFT Version 10, October 29, 2001****
B. Information Needed from Occupant/Resident
1. Has area been cleaned since WTC event
Yes No
2. If YES to Question 1,
Date(s) of cleaning
( 3. Description of cleaning
wet mopping
dusting
sweeping (Broom, vacuum, HEPA vacuum)
carpet cleaner
22Z^app]iances cleaned (surface and beneath, including refrigerator coils, dryer vents)
(describe)
furniture removed/cleaned (describe)
window treatments (curtains, etc) removed/cleaned (describe)
Other (describe)
4. Who conducted the cleaning
Tenant/occupant
Building owner/operator
Cleaning company (provide name)
5. Was visible dust present prior to cleaning?
Yes No
If YES, describe
6. Is dust still present?
Yes No
If YES, describe
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