NYC 9/11 Public Portal Document
FIRE SA. ."Y DIRECTOR ON SITE EXAMINATION --OF E
Section D:
VII. Comments by Examiner.
The Class E system was inoperative, candidate was advised to sand in an affidavit indicating proper instruction has been provided and system
Check If is operative. If so, state why system was inoperative.
applicable
Vitt 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 inspectionstexamination.
S. If the candidate satisfactorily answered the mandatory parts, but by totalling all answers, the number of NO answers were below 80%, the candidate falls
the practical test. See Chart.
IX. On Site High Rise Test—(Prnt ALL Information):
C. of R X 01 ( ® Ne. of On Site Tests _ --
Candidate Name / Z- 1r1 S ~.,. Office Address_____
T _
Social Security No. -.P1.. 1 -.-.... -.-.-.-.-.-•-.-....
------------------------------------------------ — k`
(
Date of ~/ °
Examination___________________________ v Total Number of Items Answered..__ -__._ __
Number of correct answers are on this test. Number of Incorrect answers are . Number of N/A answers are
Summary of Results:
A. PASSED or D. FAILED-(reason)
(CHECK)
CANDIDATE - -- 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 her+ebb_y certi all Information contained In this report accurate.
//
f '
INSPECTOR DATE
White copy must be given to 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 H/R (4/89) 514902se-114
NYC-WTC 000166264
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