NYC 9/11 Public Portal Document
FIRE SAFETY DIRECTOR ON SITE EXAMINATION—OFFICE
Section D:
VII. Comments b^xaminer:
( ) 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 answered 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 High Rise Test—(Print ALL information):
C. of F. Z 01 No. of On Site Tests
Candidate Name 'Y 't Office Address
Social Security No. PH T
''y
Total Number of Items Answered
7
Date of Examination
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)
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 hereby certify all information contained in this report is accurate.
' DATBT
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_000168820
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