Asbestos disposal form, WTC site, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: (

Block: Residential CommerciaTl3 Name of Building: Lot: Mix Usej Other # of Stories: S 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 j] Yes ❑ No Locations: Copies of All Reports and Data Requested Yes visual Inspection Results: Facade: Inspected Debris North ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer E]'% to 1" 0>1" South ❑ N/A © Yes ❑ No ❑ No Visible/Fine Layer ❑ Ya to 1" 0>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" 0>1" West ❑ N/A ❑ Yes L] No ❑ No Visible/Fine Layer 0'/ to 1" 0>1" Facade Description:

Roof st Debris: ❑%to1"•1 :I.-+ ❑>1" .1 ® No Visible /Fine tyer Description: I n<< --'i. 1Ja

Setbacks N/Af] Floor. Debris: ❑ No Visible/Fine Layer ❑ Y: to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/s to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %s to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑% to 1' ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1" Comments

Date: d ( 1?/2002 Inspection Team: Name: Pt- Agency: Name: uiii Si U= Agency:

NYC-WTC 000100164