NYC 9/11 Public Portal Document
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ASBESTOS INSPECTION REPORT
PREMISE NO. STREET INSPECTION DATE
FLOOR ZIP BORO CODE BLOCK LOT SQUAD a BADGE a
1S to- Arer- t c
1 R BLDC~TYPE BASIS OF INSPECT.; ~,p.~~ ._ _ PHOTOS TAKEN (YE 1 NO
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f't SAMPLE NO. W,-1•,` ~
CON ACTORS NA E
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 M INFRACTIONS RESULT CODE
NOV N SUPERVISORS INITIALS
BORO I = MANHATTAN 2 - BRONX 3 = BROOKLYN 4 = QUEENS 5 -RICHMOND
BLDG TYPE A > 6 Stories B < 6 Stories C Single Family
D 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 000109988
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