NYC-WTC_000166105

NYC 9/11 Public Portal Document

FIRE SAFETY DIRECTOR ON SITE EXAMINAIIONZ-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 stisen Check if is operative. If so, state why system was inoperative. applicable

Vill. 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 ty contacting the High Rise Unit. The examiner should also give the applicant a bill for the inspections/examination. B. If the candidate satisfactorily answered the mandatory parts, but by tctatling all answers, the number of NO answers were below Sd%, the candidate laic the practical test. See Chart. • -

IX. On Site High Rise Test—(Print ALL information): C of F. Z 0 1 _ No. of On Site Tests

Candidate Name Office Address P Social Security No.

Date of Examination _____ Total o.'!dumber 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 B. FAILED..-(reason) (CHECK)

C.;NRICATE w.n- tiUILZING Those candidates failing should contact the High Rise Unit far anctt:er • a appointment when building ccrrecdon andlor additional knowledge is crturm C. Violation numbers issued as result of examination and inspection: D. thereby certify all Information contained in this report is accurate.

• wSPEC.OR •~ ca,~

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.

NYC-WTC 000166318