Block: I Residential 0 Commercial I Name of Buii ing:
Lot: Mix Use D Oer hN1 7 uw ^
# of Stores. AKA's: — 4cn
Building Ow r/Management: Telep ne Number. ) 30—
Name: FAX:
Address:
On Site Contact:
Name: " * Telephone Number:
Building Owner Management Activities
Interior Survey Performed 0 Yes 0 No
Exterior Survey Performed ❑ Yes 0 No
General Clean Up 0 Yes[] No Locations:
ACM Clean Up 0 Yes 0 No Locations:
Air Monitoring ❑ Yes 9 No Locations:
Copies of All Reports and Data Requested 0 Yes
Visual lnsDection Results:
Facade:
Inspected Debris
H>19
North ` -N/A
South 'N/A
East [j N/A
❑ Yes 0 No
❑ Yes 0 No
., Yes [j No
No Visible/Fine Layer ❑ % to 1"
No Visible/Fine Layer '/to 1"
isible/Fine Layer H % to 1"
0>1"
9> 1"
West ! /A j] Yes 0 No j] No Visible/Fine Layer ❑ % to 1" 0>1"
Facade Des ption:
Roof
Debris: rXNo Visible /Fine 9!4t01 , 9>1"
Setbacks N/A []
Floor. Debris: 0 No Visible/Fine Layer 034 to 1" ❑ > 1"
Floor. Debris: 0 No Visible/Fine Layer ❑ h to 1" ❑ > 1"
Floor. Debris: 0 No Visible/Fine Layer 034 to 1" ❑ > 1"
Floor. Debris: No Visible/Fine Layer []'h to 1" >1"
Floor Debris: No Visible/Fine Layer ❑ % to 1" g >1"
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 292 Greenwich Street dated February 12, 2002.