NYC 9/11 Public Portal Document
FIRE TY DIRECTOR ON SITE EXAMINATI FFICE
ection D:
'll. 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 's operative. If so, state why system was inoperative.
applicable___________________________________________________________________ __________________ _____________
fill. Determination of Passing:
k. 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 (live 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 Test—(Print ALL Information):
C. of F. Z 0 J No. of On Site Tests
Candidate Name Premise Address
7/ ___ z—
Social Security No.
Total Number of Items AnswerM________ ' ^7_________ _
Sate of Examination
dumber of correct answers are. on this test. Number of incorrect answers are . Number of N/A answers are
f
Summary of Results:
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. J hereby certify all information contained In this report is accurst*.
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.
3-1 H/M (8/88) 2.870682«!S
NYC-WTC_000168891
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