Waste management and EPA emergency contact information

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: Fq1q Or -/'_J flc Il ( J . o Block: Residential U Commercial Name of Building: Lot: Mix Use ❑ Other ❑ # of Sto ies: Z, AKA's: -p- i Building Owner/Management: Tlephone 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 0 Yes ❑ No Locations: I&yr,,tvlz Cj-EArJ ,Or 7 IE ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

V I Udl Inspelruun RG*u1Lb. Facade: Inspected Debris North N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/2 to 1" South LI N/A Yes ❑ No ❑c,Ne-Visible/Fine Layer ❑ % to 1" East ® N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" West N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/2 to 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ®'/2 to 1" ❑ > 1" Description: Pe-4-i ;:,r-,c.er 4 j -M 3- ,, 5 Fr sfrLit'- 2, ya F1'Dy

Setbacks N/A [0 Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

Date: L/ 2 L /2002 .r Inspection Team: Name: I , , f P~Sri c k Agency: L' SGPR Name: R • R e-y'11, wwh e,.v, Agency: Nti c Dc- P !FLA NYC-WTC-000112145