WTC Visual Survey Form
Premise Address:
q7 _ 9- to i )Gayle sy.eeJ7
Block: ResidentialD Commercial f Name of Building:
Lot: Mix Use D Other
# of Stories: 7j-pg AKA's:
Building Owner/Management:eucrr mb p . pTs Telephone Number: (2 / ) q'
vei
p
ict ,o .
Name: FAX:
Address:
On Site Contact: jjy qJ
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
D•• Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A Yes ❑ No 10No Visible ❑ i4 to 1" E]> 1"
South ❑ N/A M.Yes ❑ No ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Via to 1" 0> 1"
Facade Description:
Roof
Debris: ® No Visible ❑ % to 1" 0>1'
Description:
Setbacks N/A
Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" 0>1.
Floor: Debris: ❑ No Visible/Fine Layer ❑ V2 to 1" 0>1'
Floor: Debris: ❑ No Visible/Fine Layer ❑V:to 1" 0>1'
Floor: Debris: ❑ No Visible/Fine Layer ❑V to 1" 0>1'
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0>1'
Comments
Date: S/ o) /2002 Inspection Team: Name: Rfl7'1 Agency: -pap-
Name: ' Agency:
N T E R E O`
NYC-WTC-000114538
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000114538Source: NYC Law Department, mirrored locally
Letter from DEP Commissioner advising building owners on post-collapse maintenance, re-occupancy issues, and hazardous material assessments including asbestos.