NYC 9/11 Public Portal Document
FIRE S^TY DIRECTOR ON SITE EXAMINATIQ^OFFICE
lection D:
/II. Comments by Examiner:
( ) The Class E system was inoperative, candidate was advised to send in an affidavit indicating proper instruction has been provided and system
Check if '® operative. If so, state why system was inoperative.
applicable -------------------------- ---------------------------------------------------------------------------------------------------------------- ---------------------------------
/III. Determination of Passing:
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.
3. 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.
X. On Site Office Building Tost—(Print ALL Information):
C. of F. Z 01 No. of On Site Tests
...... Premise Address
Social Security No.
PH A/.
Total Number of Items Answered
/ '
Oate of Examination
dumber of correct answers are. Number of incorrect answers are . Number of N/A answers are
Summary of Results:
PASSED _______ or B. FAILED-treason)
(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.
✓
INSPECTOR DATE
Whits 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.
>1 H/M (8/88)
NYC-WTC_000168890
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