WTC Visual Survey Form
lii Premise Address:
93 Pa, a -4e c
S e o- -' 4 ro-O
Block:-' Residential 0 Comme'Pcial 0 Name of Building:
Lot: Mix Use J J Other
# of Stories: AKA's:
Building Owner/Management: I Telephone Number: ( )
Name: 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 0 Yes
visual inspection Kesuits:
Facade:
Inspected Debris
North ❑ N/A ® Yes ❑ No No Visible er % to 1' ❑ > 1"
South ❑ N/A EYes ❑ No Ef No Visible ❑'/_to 1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer F]'h to 1" 0>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1"
Facade Description:
eva e
+ e
Roof
Debris: No Visible /Fine Layer ❑ % to 1" ❑ > 1"
Description:
Setbacks N/A
Debris: ❑ No Visible/Fine Layer ❑ % to 1"
,
s
Floor: ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ 4 to 1' ❑ > 1'
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 % to 1" ❑ > 1'
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 311 Greenwich Street dated February 12, 2002.
WTC debris inspection form documenting visual inspection results for facade condition, ACM assessment, and building characteristics for a 3-story structure.