DEP contact form, 48 Warren Street, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 4 W ST Block: Residential lJ Commercial El Name of Building: Lot: Mix Use fa Other El # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: S ~- S(c r C,:21f 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 l/A ❑ Yes ❑ No ❑ No Visible/Fine Layer El 14 to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ['No Visible/Fine Layer El 14 to 1" ❑ > 1" East /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" West• N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer El 14 to 1" ❑ > 1" Facade Description:

Roof

Debris: o Visible /Fine Layer ❑%to 1" ❑> 1"

Setbacks N/A ❑i' Floor: Debris: ❑ No Visible/Fine Layer El 14 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 14 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer El 14 to 1" E> 1" Floor: Debris: ❑ No Visible/Fine Layer El 14 to 1" ❑ > 1"

Comments - C~ks in bl nC PII

Date: f/ Inspection Team: Name: Agency: Name: F- v 1 Agency: L

NYC-WTC- 000113339