Asbestos inspection report form, 22 Warren Street, undated

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: ResidentialD CommercialU Name of Building: Lot: Mix Use OtherfJ $ of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: V)cL4- y.€ LLC, FAX: Address: On Site Contact:: t Name: * * Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes Q No Locations: Air Monitoring Q Yes Q No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: L Facade: Inspected Debris North 0 N/A ❑ Yes Q No ❑ No Visible/Fine Layer ❑ % to l' 0>1' South ❑ N/A ❑ Yes Q No ❑ No Visible/Fine Layer $

4 to 1" r ❑ > 1" East Q N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Va to 1' ❑ > 1" West Q N/A ❑ Yes Q No ❑ No Visible/Fine Layer ❑ i4 to 1" 0>1' Facade Description: lc

Roof

Debris: ❑ No Visible /Fine r 1' ' ❑ > 1' Description: t

Setbacks Floor. Debris:D No Visible/Fine Layer 0 % to 1' 0> 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1' Floor. Debris: Q No Visible/Fine Layer Q % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer 0 % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer D % to 1' 0301,

Comments

Date: r/

12002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000112733