DEP letter requesting environmental assessments, Feb 2002

NYC 9/11 Public Portal Document - WTC Visual Survey Form p emise Address:

Block: Residential Commercialp Name of Building: Lot: p Mix Use J Other # of Stories: i AKA's: Building Owner/Mann ement: Telephone Number: ( ) Name: ~- FAX: Address: On Site Contact: ; ---------------------------------------------------------- Name: ti f Telephone Number: P11 Building Owner Management Activities ------------------------------------------------------------- Interior Survey Performed Q"Yes ❑ No Exterior Survey Performed Q Yes ❑ No General Clean Up E3Yes ❑ No Locations: ACM Clean Up ❑ Yes O No Locations: Air Monitoring ❑'Yes ❑ No Locations: Copies of All Reports and Data Requested EYes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ['Yes ❑ No ❑ No Visible/Fine Layer ❑/2to1" ❑>1" South ❑ N/A Q'Yes ❑ No ❑ No Visible/Fine Layer D'/2 to 1" D>1 East ❑ N/A Q Yes ❑ No ❑ No Visible/Fine Layer ❑/2to1" ❑>1" West ❑ N/A QYes ❑ No ❑ No Visible/Fine Layer ❑/zto1" ❑>1" Facade Description•

Roof ~yzs~ Debris: No Visible /Fine ayer ❑ / to 1" •? =~"'` ❑ > 1" Description:

Setbacks N/As 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 I" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Comments

Date: ~/ 24"/2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC-000117402