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NYC-WTC_000204597
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NYC 9/11 Public Portal Document
NEW YORK CITY BOARD OF EDUCATION GENERAL FIELD VERIFICATION FORM
NAME OF THE CONSULTING FIRM: ATC Associates Inc. SPECIFICATION NO.:
SCHOOL: ADDRESS:
TYPE OF SERVICES PROVIDED: (check as applicable)
O ASBESTOS TECHNICIAN □ PROJECT DESIGNER* 0MISC. CONSULTING SERVICES □ AIR SAMPLING TECHNICIAN □ PROJECT MONITOR
LOCATIONS(S): i/6L/y WORK PERFORMED: //?
DATELSS TIME NAME OF THE NAME & SIGNATURE IN OUT PROFESSIONAL OF AUTHORIZED PERSONNEL CUSTODIAN/PRINCIPAL w ..wr'- ji ’■JUtr
T signature name (print) signature
oi ~ ~ ^2, fO: 0-0 o2
I
o H NOTE; Please complete the following as applicable, indicate "N/A" if not applicable. K I Asbestos Inspector's no. of school visits: s Q Air Sampling Teclinician's no. of school visits: I—i o ‘Minimum payment for Project Designer's services shall be four (4) times the unit price per hour. o I o Project Monitor's total no. of hours: o o CO LO Mise, consulting services no. of hours: co o
NYC-WTC_000204597
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NYC-WTC_000204597Source: NYC Law Department, mirrored locally
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General field verification form documenting asbestos technician services performed at school PS 25LH by ATC Associates.
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