WTC Visual Survey Form
Preriilso"AdO ss:
7yTr
5~~• T j ,
Block: Residential Corn cial Name of Building:
Lot: Mix Use Other '
# of Stories: AKA's:
Building Owner/Management: Telephone Number.( )
Name: G FAX:
Address:
On Site Conta t:
Name: ' ' d~ (S'~rwA-L-2yelephone Number.
Building OWner Managem nt 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 0 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑34to1' ❑>1'
South ❑ N/A ❑ Yes [] No ❑ No Visible/Fine Layer ❑%tol' 0>1'
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑htol' 0>1'
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 4 to l' 0>1'
Facade Description:
Roof
Debris: 0 No Visible /Fine Layer . (i' to 1' ❑ > 1'
DeScriotion:
Setbacks N/A~
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1'
Floor. Debris: 0 No Visible/Fine Layer ❑ i4 to 1'
Floor. Debris: ❑ No Visible/Fine Layer ❑ h to 1'
Floor. Debris: ❑ No Visible/Fine Layer ❑ 3h to 1' 9>1'
Floor. Debris: ❑ No Visible/Fine Layer ❑ i4 to 1' 0>1'
Comments
DEP inspection form for 50 Broadway documenting building characteristics, facade conditions, and asbestos-containing material survey across multiple building faces.