Environmental hazard assessment form, 33 Peck Slip

NYC 9/11 Public Portal Document <

WTC Visual Survey Form Premise Address: i. Block: I p1 Residential Commercial Name of Building: Lot: 3 Mix Use Other # of Stories: AKA's: Building ¢finer anag ment Telephone Number ( ) Name: !-&k M~ ~c FAX: Address: On Site• Contact Name: " ." Telephone Number Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes 0 No General Clean Up ❑ Yes 0 No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes 0 No Locations: Copies of All Reports and Data Requested p Yes

Visual lnsDection Results: Facade: Inspected De ris North ['Nfi- Yes ❑ No o Visible/Fine Layer ❑ h to 1" 9>1' South ®'N#A es ❑ No No Visible/Fine Layer ❑ 34 to 1' 0>1' East ❑ N/A ❑ Yes [] No 0 No Visible/Fine Layer ❑ 4 to 1' 0>1' West ❑ N/A ❑ Yes j] No ❑ No Visible/Fine Laayer ❑ % to 1' 0>1' Facade Description:

Roof

Debris: ~o Visible /Fine Layer .9 34 to V 9>1' Description:

Setbacks N/A j] Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' 0>1' Floor Debris: No Visible/Fine Layer [] 34 to 1' >1' Floor.____ Debris: No Visible/Fine Layer 4 to V > 1' Floor Floor _ Debris: No Visible/Fine Layer Debris: fl No Visible/Fine Laver 34 to V 34 to 1" R > 1' > 1'

Comments

Date: / 12002 Inspection Team: Name: Agency. Name: ENTERED

NYC-WTC-000115015