NYC 9/11 Public Portal Document
(TiArtc residential plan bctlS.wpd Page15i
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B. Questionnaire for Oceupant/Resident
1. Has area been cleaned since WTC event
_Yes __ No
2. If YES to Question 1,
Date(s) of cleaning
3. Description of cleaning
wet mopping
dusting
sweeping (Broom, vacuum, HEPA vacuum)
carpet cleaner
furniture removed/cleaned (describe)
window treatments (curtains, etc) removed/cleaned (describe)
Other (describe)
4. Who conducted the cleaning
Tenant/occupant
Building owner/operator
Cleaning company (provide name)
5. Was visible dust present?
__ Yes __ No
If YES, describe
6. Is dust still present?
_Yes __ No
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CITY_21MC100_013489437
NYC-WTC_000178103
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