WTC Visual Survey Form 1~N 100121 7
Premise Address: n assau ~-~ ree+-
014 -L-
Block: Residential , ~ J Commercial Name of Building:
Lot: 2 q Mix Use 0 Other 0
# of Stories: AKA's:
Building Owner/Management: Telephone Number. ( )
Name: FAX:
Address:
On Site Contact:
Name: Telephone Number. {
Building Owner Management Activities
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested Yes
Visual inspection Results:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0 %/4to 1 " 0 > 1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0 1/2 t01" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/tol " 0>1 "
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" 0>1"
Facade Description:
Debris: Qo Vi ible ine Layer )'/ to 1" > 1"
Description: I&oo4 tat.
Setbacks N/A ❑
Floor: Debris: ❑ No Visible/Fine Layer ❑ 1 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑'% to 1" 0> 1"
I Comments
Date: c2 / I q /2002 Inspection by: Name: CL Agency: ICE P
Name: Agency:
41
NYC-WTC 000098754
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NYC-WTC_000098754Source: NYC Law Department, mirrored locally
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 292 Greenwich Street dated February 12, 2002.