WTC Visual Survey Form
Premise Address:
lb VII R RED STREET
Commercial 0
Block: Residential Name of Building:
Lot: Mix Use ❑ Other ❑
# of Stories: t AKA's:
Building Owner/Management: Telephone Number. ( )
Name: Ci 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:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" [1> 1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer fl 1/2 to 1" ❑ > 1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1"
Facade Description:
Roof
Debris: ❑ No Visible /Fine Layer El
1/2 to 1" ❑ > 1"
Description:
Setbacks N/A ❑
Floor: Debris: ❑ No Visible/Fine Layer ❑'% to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" n> 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'% to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1"
Comments
).
Date: I / /2002 Inspection Team: Name: n G / SAgency: kt ii
Name: L r n Agency:
Department of Environmental Protection letter dated February 12, 2002, requesting building owners to submit environmental hazard assessments for 54 Warren Street.
6 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.989
WTC debris inspection form documenting visual inspection results for facade condition, ACM assessment, and building characteristics for a 3-story structure.