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Construction Site Inspection Report Form Appendix G (continued) NE\YYORKSTATI: DEP.-IRThlENT OF E.""\lRONl\lE.NTAL C:ONSE!l\".UION DI\1s101' OF W.HER AOClll:onai ~ : o PtlO!•apns albctieo o.-aau 1nspect on Rating: □ s a11SraC-:OfY ::I 1,Catglrtal a unsall5fac'lory NameJA~ocy or Leaa tnspector: I sig:iatu~ 0-1 LUO IMpee>:oc. Nama-S!A~nele& or O!Mr rnspee«>rg: 12