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WTC Visual Survey Form
Prcmis, Address: /
pt__
Block: Residential Comme ial J Name of Building:
Lot: I, Mix Use Other
# of Stories: AKA's:
Buildin OwpejIMprjamqpt 2 Telephone Number
Name: 0
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 Results:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Ya to 1" 0>1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Ya to 1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Ya to 1" []>?
West ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ 34 to 1" ❑ > 1"
Facade Description:
Roof
LN Y4
Debris: Visible /Fine yer ❑ Y to 1" 1~""' ❑ > 1" `
Description:
Setbacks N/A t
Floor. Debris: ❑ No Visible/Fine Layer 034 to 1" ❑ > 1"
Floor. Debris: 0 No Visible/Fine Layer ❑ a to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor. Debris: [] No Visible/Fine Layer ❑ h to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Comments
Date: inspection Team: Name: Agency:
Name: Agency:
gNTER S
NYC-WTC 000116979
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000116979Source: NYC Law Department, mirrored locally
DEP inspection form for 50 Broadway documenting building characteristics, facade conditions, and asbestos-containing material survey across multiple building faces.