Asbestos inspection form, 54 Pine Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form 10®1010 Promise Address: 5 j- P /nrt STg&6r Block: Residential 0 CommercialD Name of Building: Lot: Mix Use I J Other # of Stories: I AKA's: Building Owner/Management: 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 j j Yes

visual inspection Nesults: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No VSible/Fine Layer ❑%tol" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ❑%to 1" 0>1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > I" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'% to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Date: -I/_/2002 Inspection Team: Name: f,1" Agency: OP Name: Agency:

NYC-WTC-000114854