47 West Street Form Record, DEP Box 39

NYC 9/11 Public Portal Document

WTC Visual Survey Form ,, Premise Address: T ' - Block: Residential 9 Commercial Name of Building: Lot: Mix Use Other # of Stories: 5 AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: " - Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ 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:

In pected rie North South ❑ N/A ❑ N/A Yes ❑ No ❑Yes❑No g o Visible/Fine Layer ❑ No Visible/Fine Layer ❑Vtol" ❑'/ to 1" 9>1" 0>1' East ❑ N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑vtol" 0>1' West ❑ N/A Facade Description: A yes ❑ No .0f1o Visible/Fine Layer ❑ Va to l" 0>1'

Roof Debris: ❑ No Visible /Fine Layer ❑%to1" 0>1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer 0 V2 to? 0>1' Floor. Debris: ❑ No Visible/Fine Layer ❑ a to? [3> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" 0>1' Floor. Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1" Comments

Date: Inspection Team: Name: L41 "- s-

Agency: Y J '.- Name: Agency:

NYC-WTC 000110009