Block:#' Residential Commercial U Name of wilding:
Lot tjf Mix Use 0 OtherjJ
# 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 Q No
Exterior Survey Performed [] Yes Q No
General Clean Up Yes 0 No Locations:
ACM Clean Up g Yes 0 No Locations:
Air Monitoring ❑ Yes 0 No Locations:
Copies of All Reports and Data Requested Yes
visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A DYeSDNó ❑ No Visible/Fine Layer ❑%to 1' 0>1'
South NIA Yes No No Visible/Fine Layer ❑'% to l' 0>1'
East N/A Yes No No Visible/Fine Layer 0hto1' 0>1'
West N/A Yes 0 No No Visible/Fine Layer ❑hto 1' 0>1'
Facade Description: r, n „
Roof
Debris: MJNo Visible /Fine Layer .9% to V 9>1'
Description:
Setbacks N/A~
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 % to 1' > 1'
Floor Debris: No Visible/Fine Layer h to 1' >1'
Comments
Date: J I t12OO2 Inspection Team: Name: Agency:
Name: Agency:
NT E RE2
NYC-WTC 000109724
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000109724Source: NYC Law Department, mirrored locally