Building inspection form for 51 Nassau Street regarding ACM and

NYC 9/11 Public Portal Document

WTC Visual Survey Form $(J I O79031. Premise Address: 51 as o f oc 0 ffiai c e rl Lane- Block: (o 4 Residential 0 Commercial 0 Name of Building: Lot: I 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 I 1 Yes

visual Inspection K@sults: Facade: Inspected Debris North South East West ❑ N/A ❑ N/A ❑ N/A ❑ N/A Facade Description: ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ No Visible/Fine Layer ❑ No Visible/Fine Layer ❑ No Visible/Fine Layer t to 1" to 1" to1" to 1" ❑> 1" ❑> 1" >1" 0>1"

Roof

Debris: ❑ No Visible /Fine Layer 101" ❑>1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"

Comments

Date: ) //2002 Inspection by: Name: 1 P Agency: 1)EP Name: Agency:

NYC-WTC 000099806