NYC 9/11 Public Portal Document
FIRE SAf4I director ON SITE EXAMINATION—^ICE
Section D:
VII. Comments by Examiner:
( ) The Class E system was inoperative, candidate was advisedly send in an affidavit indicating proper instruction has been provided and system
is operative, if sb, state why system was inoperative. _ a <
Check if
applicable
VIII. Determination of fussing:
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 wore below 80%, the candidate fails
the practical test. See Chart.
IX. On Site Office Building Tost—(Print ALL Information):
Q of F Z 01_ No. of On Site Tests
—"tY..
Candidate Name__ _- Premise Address 7 ■
PH
Social Security No. ----------------- ------------- - - -
J - )■- f'- Total Number of Items Answered
J J
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 examlnatlon ^nd Inspection: D. I hereby certify all information contained In this report Is accurate.
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.
ID-1 H/M (8/88) 2.87O682-R26
NYC-WTC_000168866
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