NYC 9/11 Public Portal Document
PAGE3OF _
ASBESTOS INSPECTION REPORT
PREMISE NO. STREET INSPECTION DATE
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FLOOR I ZIP BORO CODE BLOCK LOT I SQUAD a BADGE K
F, S l - '° - I I
I R BLDC~TYPE BASIS OF INSPECT. Q.~~ PHOTOS TAKEN (4 I NO
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CON ACTORS NA {~ SAMPLE NO.
ADDRESS CITY SAMPLE NO.
STATE ZIP PHONE SAMPLE NO.
LABORATORY NAME OWNERS NAME
ADDRESS CITY ADDRESS CITY
STATE ZIP PHONE STATE ZIP PHONE
CONTACT PERSON: TIME OF INSPECTION FROM: am/pm TO: am/pm
INSPECTION DISCLOSED:
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NOV N INFRACTIONS RESULT CODE
NOV p SUPERVISORS INITIALS
BORO 1 - MANHATTAN 2 = BRONX 3 = BROOKLYN 4 = QUEENS 5 =RICHMOND
BLDG TYPE A > 6 Stories B < 6 Stories C Single Family
0 School E Hospital F Public Owned Property
RESULT CODES 1 = Violation Issued 2 = No Violations Issued 3 = No Access
4 = Project not Started (No NOV) 5 = Project Completed (No NOV) ACP 30/93
NYC-WTC 000109847
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