Asbestos inspection form, 81 Warren Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential Commercial El Name of Building: Lot: Mix Use Other ❑ # of Stories: AKA's: Building Ow ana ement: Telephone Number: ) 7 / —555 m FAX: ç f ) J — 56SO 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: In ected North ❑ N/A [ Yes ❑ No ~NoisVisible/Fine Layer ❑ Y2 to 1" [J>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" West , ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Roof

Debris: ❑ No Visible /Fine Layer El 1/2 to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/2 to 1"

Date: ~/ /2002 Inspection Team: Name: ency: &ktDOL Name: ency:

NYC-WTC-000112848