WTC building inspection form asbestos assessment 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 5l Block: 1 ) Residential 0 Commercial J Name of Building: Lot: Mix Use J J Other # of Stories: ç AKA's: Building Owner/Manageme t: Telephone Number: ( ) Name: "5. FAX: Address: O0 - a 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 ❑ /2 to 1" ❑ > 1" South ❑ N/A Q Yes ❑ No ❑ No Visible/Fine Layer B'/2 to 1" []> 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Facade Description:

Roof

Debris: [] No Visible /Fine yer © Y to 1" 1 0>1" .1 Description: i-i z

Setbacks N/A Q ► 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 0Y to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %: to 1" ❑ > 1"

Comments n _-

Date: "_/7/2002 Inspection Team: Name: Agency: Name: Kt i ZK Agency:

NYC-WTC-000100318