Premise Address:
WTC Visual Survey Form (0 QUQ
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Block• Qu Residential 0 Commercial p Name of Building:
Lot: I . Mix Use JJ Other
# of Stories: AKA's:
Building Owner/Management:
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Telephone Number. ( )
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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 Yes
visual inspection Kesuits:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" 0>1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"
East ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ Y to 1" 0>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ % to 1" 0>1"
Facade Description:
I Roof
Debris: ❑ No Visible /Fine Layer ❑% to 1" '1> 1"
Setbacks N/A ❑
Floor. Debris: ❑ No Visible/Fine Layer ❑ V 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 ❑ % to 1" 0>1"
Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Comments
Date: cc) / 17 /2002 Inspection by: Name: CG Agency: De P
Name: Agency:
NYC-WTC- 000115758
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000115758Source: NYC Law Department, mirrored locally
A Department of Environmental Protection letter advising on building maintenance and contamination assessment following the World Trade Center collapse.
Letter from NYC DEP to building owner requesting information regarding building contamination assessment and asbestos evaluation following World Trade Center collapse.
Joint memorandum from NYC DEP and DOH advising building owners on post-9/11 maintenance, re-occupancy issues, and hazardous material assessments including asbestos.
NYC Department of Environmental Protection inspection form documenting visual inspection results for facade and roof debris conditions at a WTC-affected building.