WTC environmental inspection form, 395 South End Avenue, undated

NYC 9/11 Public Portal Document

I WTC Visual Survey Form Premise Address: r t3- ' *t EcYd a L5

Block: Residential Commercial p Name of Building: Lot: Mix Use Other j J # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: - , +~-- W ~~a L FAX: Address: On Site Contact: ~~ ~ ~+ Name: • {'"~' `~' ~~= Telephone Number: (21)—) 2 + Building Owner Management Activities Interior Survey Performed [Yes ❑ No Exterior Survey Performed OYes ❑ No General Clean Up [Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes 2No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" 0>1" South ❑ N/A [aYes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" East ❑ N/A []"Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" West ❑ N/A [,Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" Facada Descnption • $5rr'W.v (,tiw.ftlws e.4

Roof

Debris: ❑ No Visible /Fine ayer ❑ 1/ to 1" 1 j> 1" 1 Description: '- - -7iS ( fl -' ti' < t4f

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

Comments t

Date: / /2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000117608