NYC 9/11 Public Portal Document
4
FIRE SAFETY DIRECTOR ON SITE EXAMINATION—OFFICE
Section D:
VII. 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 __________________________________________ :-----------------------------------_____________________________________________ _
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 Office Building Test—(Print ALL information);
C. of F. Z 01 No. of On Site Tests i
Candidate Name. Premise Address.
Social Security No. PH / / / / n U
Date of Examination Total Number of Items Answered
Number of correct answers are__2L;^^ on this test. Number of incorrect answers are
. Number of N/A answers are
Summary of Results:
A. PASSED or B. FAILED—(reason)
«
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 ^11 information contained in this report IS accurate.
Knm_____
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.
;D-1 H/M (8/88) 2^2.R2s
NYC-WTC_000168765
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