NYC 9/11 Public Portal Document
tvty a r b I LM I VALUATION
_____________________
Lil i iL,ts t
FORM
Please complete this form in accordance with
instructions in the accompanying guidance
document
Part 1.0 General Information .
Date ofevaluation: 1/ 15703
C Building contact name and phone:
Evaluation team (list name and affiliation):
CHI L bJV. z (Environmental professic
A 1 i'
i
D)STE (HVACprofessjonal)
Building address: Type of Facility (check all that apply):
vE Residential
//_ w N)21. A.).!. 'A..t.:..-- -
Other (describe)
Date of construction:
Number of residential units:
Number of floors:
Prior inspection report/maintenance records
available for review?:
Other comments
d
Ventilation system types (check all that and indicate total no. of units
Central ventilation system
Mechanical exhaust system
Est: no. of units . f Est. no. of units
Mechanical make-up air system
Passive shaft/duct
Est. no. of units
Est. no. of units l
Other (describe)
I certify that to the best of my
knowledge, the
including all attachments are a true and accurate information and observations recorded on this form
representation of site conditions.
Ventftit* te (H }Evaluator' Date//
P r sual Inspection Forms
Use the attached forms to document
visual inspections. Complete the forms in
instructions In the accompanying guidance accordance with
document.
NYC-WTC 000117896
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000117896Source: NYC Law Department, mirrored locally
An HVAC inspection report from Cole Consulting Corporation dated February 13, 2003, recommending cleaning of units at 275 Greenwich Street due to WTC dust.