NYC-WTC_000166105

NYC 9/11 Public Portal Document

FIRE SAFETY DIRECTOR ON SITE EXAMINATION-OFFICE Section D: VII. Comments by Examiner: ( ) The Class E system was inoperative, candidate was advised to send in an affidavit indicating proper instruction has been provided and system Check if is operative. If so, state why system was inoperative. applicable -

VIII. Determination of Passing: A. If the candidate failed to answer satisfactorily the essential questions marked (•), advise the candidate that a new appointment should be requested by contacting the High Rise Unit. The examiner should also give the applicant a bill for the inspections/examination. B. If the candidate satisfactorily answerad the mandatory parts, but by totalling all answers, the number of NO answers were below 80%, the candidate fails the practical test. See Chart,

IX. On Site Office Building Test—(Print ALL information): 0 . ~, -in — ry C. of F. Z 01 A? a" - No. of On Site Tests

Candidate Name d d Premise Address W fi t. p Social Security No. ._._._._._._._._._._._._._._._._._r.1.1._._._._._._._._._._._._._._._._._.a- 14 Date of Examination e2 & Total Number of Items Answered -

Number oferect answers are on this test. Number of incorrect answers are . Number of N/A answers are ( {j Summary of Results: A. PASSED or B. FAILED—(reason) —/ (CHECK)

UANUIuAI a BUILDING Those candidates failing should contact the High Rise Unit for another appointment when building correction and/or additional knowledge is obtained. C. Violation numbers Issued as result of examination and Inspection D. I f ereby certify all Information contained In this report is accurate.

__-.. 1Pf PECTOR _ _ DATE r . ft ? White copy must be given tc the Candidate. Canary copy must be submitted to the High Rise Unit. INSPECTORS ARE ONLY PERMITTED TO PROVIDE CANDIDATES WITH Pink copy must be submitted to Cashier's office. SECTION D. FSD-1 HIM 18/830 2$7Js9'_ R25

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NYC-WTC 000166120