WTC Visual Survey Form B t t O0 127.S
Premise Address: i re~~
a a 5
Block: 2, Residential Commercial ~~ Name of Building:
Lot: 27 Mix Use ❑ Other
# 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 ebris
North ❑ N/A ❑Yes ❑ No No Visible/Fine Layer ❑'/ to 1" ❑>1"
South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer fl 34 to 1" ❑> 1"
East ❑ N/A ❑ Yes ❑ No El No Visible/Fine Layer ❑ /2 to 1" ❑>1"
West ❑N/A ❑Yes[]No No Visible/Fine Layer ❑ /2 to I" 0>1"
Facade Description:
Roof
Debris: ❑ No Visible /Fine Layer /2 to 1" ❑ > 1"
Setbacks N/A ❑
Floor Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑v2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"
Comments
Date: / / 9 ,/2002 Inspection by: Name: CC Agency: DE P
Name: Agency:
NYC-WTC 000098828
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000098828Source: NYC Law Department, mirrored locally
Joint memorandum from NYC DEP and DOH advising building owners on post-9/11 maintenance, re-occupancy issues, and hazardous material assessments including asbestos.