DEP environmental document request, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 1 1 a 1 Block: Residential 0 Commercial D Name of Building: Lot: Mix Use D Other # of Stories: 5 AKA's: Building Owner/Management: Telephone Number: ()'Z) 3q, ? 3Z2 Z Name: 5 ict= Q 5 4 FAX: Address: On Site Contact: Name: ' Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes 0 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 DYes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/a to 1" 0>1" South ❑ N/A [2 Yes ❑ No ❑ No Visible/Fine Layer E]'/s to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0'/a to 1" 0>1" Facade Description: (Mt(ws aE. ~'1►ul~CS,.I-S t~t 1~~-t

Roof w~ Debris: ❑ No Visible /Fine Layer ❑ % to 1" •? = ❑ > 17 1 _'''? Description: 1P, "~ P2- , c'—,) F'r', c A ~; Z Rc124; 1

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer ❑ va to 1' ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/a to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer L] % to 1" ❑ > 1' Comments t\ Sri! t.e -r IN i f: ) fi i) I P. 5'

Date: _(S i I 21 12002 Inspection Team: Name: AL Agency: Name: #-Ii►.4 tH Lt Agency:

NYC-WTC 000100444