250 SOUTH END av 1065089, 16/7503

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~o0TRE~ f}v~nly~ Block: Residential Commercialp Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management IRy /»~.n€mif-. Telephone Number. (z/z.) 5- 3q_777/ Name: FAX: ( i as Address: On Site Contact ► Name: " ' 4 ew Telephone Number.; P II Building Owner Management Activities -.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-. Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring ❑ Yes [J No Locations: Copies of All Reports and Data Requested Yes

Visual inscection Results: Facade: Inspected Debris North ❑ N/A 'Yes 0 No No Visible/sine-Layer [] %a to 1" O>1" South 0 N/A EjYes ❑ No No Visible DYato 1" O>1" East ❑ N/A Yes ❑ No No Visible r ❑ % to l" O>1" West ❑ N/A R Yes [Q No No Visible ❑%to 1" O>1" Facade Description:

Debris: 0 No Visible /Fine Layer ,® % to 1" ❑ > 1" Description: 2ee Gyvrw~ ry'ic.%9C C1i t&. w rc. \.

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer 014 to 1" 0>1" Floor Debris: 0 No Visible/Fine Layer ❑ h to 1' > 1" Floor. Debris: ❑ No Visible/Fine Layer D4 to 1" > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/to 1" O> 1" Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" O>1"

Comments

Date: 0 t 1 1O 1203 Inspection Team: Name: R ' R A m rrio 4I9/ Agency: P C !EP. Name: Nl,1Goe& s c6n,- 10 Agency: Us a PA ENT RE3

NYC-WTC-000117418