DEP request for environmental data, March 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100-3q Premise Address:

Block: f25 U Residential Commercialp Name of Building: Lot: 9...Cj Mix UseD Other ft of Stories: AKA's: 7— Buiiding n r/Man ement Telephone Number ( ) Name: '1 FAX: Address: 7L i 4 \/l .M 7" (4. /00 1 On Site Contact: Name: ' .. . Telephone Number. Building Owner Management Activities Interior Survey Performed Yes 0 No Exterior Survey Performed Yes No General Clean Up ❑ Yes 0 No Locations: ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring j] Yes 0 No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade:

North South 0 N/A ON/A Ins ected es 9 No ❑YesDNo ❑ Yes O No jFNo Visible/Fine Layer Visible/Fine Layer 0%to1' ❑ % to 1' D%to 1' 9>1' 9>? 9>? East West B N/A NIA Facade Description: OYesONo Visible/Fine Layer Visible/Fine Layer 0%to V D>1

Roof

Debris: No Visible /Fine Layer .L] % to 1' 9>? Description:

Setbacks N/AD Floor Debris:L] No Visible/Fine Layer ❑ y4 to V Floor____ Debris: 0 No Visible/Fine Layer [J % to 1' Floor Debris: 0 No Visible/Fine Layer % to? Floor Debris:D No Visible/Fine Layer )4 to 1' Floor Debris:[] No Visible/Fine Layer % to?

Comments

Date: /t12002 Inspection Team: Name: Agency. Name: Agency:

NYC-WTC 000093551