WTC Asbestos Inspection Form, 130 West Broadway

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential 9 Commerci N° Jq of uiiding: Lot: Mix Use Other ,,,.,.1~ ~.+e a4. J- # of Stories: AKA's: Buliding Ow er/Management: Telephone Number. ( ) Name: FAX: Address: On Site Contact: Name: " " Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes Q 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 ,J4ZA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1' [J>1' South ❑ N/A OYes 0 No 'No Visible/Fine Layer ❑ 36 to 1' ❑ > 1" East ❑ N/A $Yes ❑ No No Visible/Fine Layer ❑'h to 1' 0> 1' West ZN/A []Yes ❑ No DNo Visible/Fine Layer ❑ Va to 1' 0>1" Facade Description:

Roof

Debris: Visible /Fine Layer .936 to V 9>1' Description:

Setbacks N/A=] Floor. Debris: ❑ No Visible/Fine Layer 934101" 0>1' Floor. Debris: ❑ No Visible/Fine Layer a h to 1" [] >1' Floor. Debris: No Visible/Fine Layer % to l' a > 1' Floor Debris: No Vsible/Fine Layer 3410 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer % to 1' 9> 1" Comments

Date: ' l ' /2002 Inspection Team: Name: CfIICL Agency: Name: Agency: • e NTEREQ NYC-WTC-000109644