NYC-WTC_000166105

NYC 9/11 Public Portal Document

FIRE SAFI ' DIRECTOR ON SITE EXAMINATION— =ICE Section D: Vii. Comments by Examiner. : The Class E systetn was inoperative, candidate was advisedto send In an affidavit Indicating proper instruction has been provided and system Check if is opergtive. If so, state why syttem was inoperative. applicable

VIII. Determination of Mssing: 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. B. It 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 Office Building Teat—(Print ALL Information): _ ----~'- C. of F. Z 01 _ Na of On Site Tests Candidate Name `~ ~ c l —_- -- Premise Address _ Social Security No..a.-.-.-.-.--.- PII a" Date of Examination // Total Number of Items Answered__._ 1` 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. FAILEDD—(roason) (CHECK)

CAND:DATE 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•.resuit of examination ønd Inspection: D. 1 hereby certify,all Information contained In this report is accurate.

/ IN$PECJCR F DATE r

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-i H/M (8/88) 2470582-R25

NYC-WTC 000166190