WTC Visual Survey Form
Premise Address:
47
Block: Residential Q Commercial Name of Building:
Lot: Mix Use 0 Other
#of Stories: ' AKA's: 47_4gwve S`
Building Owner/Management: Telephone Number: ( )
Name: FAX:
Address:
On Site Contact: ;
Name: ' Patd 2ir7 Telephone Number P 11
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:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" ❑>1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1"
Facade Description:
Roof
Debris: E(No Visible ❑ % to 1" 0>1"
Description:
Setbacks N/A ~(
Floor Debris: ❑ No Visible/Fine Layer ❑ Y 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: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Comments
Date: 6 /_/2002 Inspection Team: Name: i M1V74W Agency:
Name: Agency:
.E N T E R E 3
NYC-WTC-000110021
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000110021Source: NYC Law Department, mirrored locally
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 292 Greenwich Street dated February 12, 2002.