Block: Residential , C mmercial Name of Building:
Lot: Mix Use ❑ Other ❑
# of Stories: -)" AKA's:
Building Owner/Ma agement: Telephone Number: (
Name: '4 '' rc l Il l Ci,k-c'- FAX: ( )
Address:
On Site Contact: v '
Name: 'Y Telephone Number: ( )
Building Owner Manageithent Activities
Interior Survey Performed [1 Yes ❑ No
Exterior Survey Perfo ed I2'Yes ❑ No
General Clean Up El Yes ❑ No Locations:
ACM Clean Up ❑ Yes, No Locations:
Air Monitoring E'Yes ❑ No Locations:
Copies of All Reports and Data Requested EI\'es
Visual Inspection Results:
Facade:
Ins ected Debris
North ❑ N/A [7Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"
South ❑ N/A [Yes ❑ No No Visible/Fine Layer ❑Yzto 1" 2>i'
East ❑ N/A ❑-Yes ❑ No No Visible/Fine Layer ❑Y2to 1" E>1"
West ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer ❑%2 to 1" E>1"
Facade Description.
Roof
Debris: ❑ No Visible /Fine ayer ❑ 1/ 2 to 1" 1 - ❑ > 1" 1
Description:
Setbacks N/A N
Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"
Comments
I
Date: I/ 2 S~/2002 Inspection Team: Name: Agency: del
Name: Agency: f'
NYC-WTC-000113970
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000113970Source: NYC Law Department, mirrored locally
Department of Environmental Protection letter dated February 12, 2002, requesting building owners to submit environmental hazard assessments for 50 Warren Street.
Multi-page form documenting World Trade Center contamination assessment for a residential or commercial building, including facade inspection checklist and environmental testing…