Asbestos inspection form, 345 South End Ave, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential j J Commercial 0 Name of Building: Lot: Mix Use J Other ❑ # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: ( ) 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 J J Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No No Visible/Finetayer ❑ %2 to 1" ❑>1" South ❑ N/A Yes ❑ No ~NoVisibi.-I.r--o.m..e..'-.a.,yp,t.ir ❑'/a to 1" ❑>1" ❑ N/A Yes ❑ No ❑ % to 1" East West ❑ N/A Facade Description: . Yes ❑ No No Visible/Eins-Eayeer j~ No Visible/Fine.Layer ❑ %a to 1" 0>1" 0>1"

Roof

Debris: ,No Visible /ine-Layer ❑ %a to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: 2 I?-? /2002 Inspection by: Name: Agency: Name: Agency:

NYC-WTC-000117439