WTC environmental hazard assessment form, 47 Broadway

NYC 9/11 Public Portal Document

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WTC Visual Survey Form Premise Address:

Block: Reside tial 0 Commercial Name Building: Lot Mix Use D Other # of Stories: AKA's: Building Owner/Management: A Telephone Number: ( ) Name: -' Jt'L 1— t- FAX: ( ) Address: On Site Contact: Name: Telephone Number: ) Building Owner Management Activities Interior Survey Performed Q Yes Q No Exterior Survey Performed Q Yes Q No General Clean Up ❑ Yes Q No Locations: ACM Clean Up ❑ Yes Q No Locations: Air Monitoring Q Yes Q No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North L] N/A ❑ Yes Q No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" South ❑ N/A ❑ Yes Q No No Visible/Fine Layer ❑ Via to 1" 0>1" East /A Q Yes Q No 4o Visible/Fine Layer Q % to 1" 0>1" West ❑ N/A Q Yes Q No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" Facade Description:

Roof ~vss~

Debris: Q No Visible /Fly:r 9 V2 to 1" •1 t ❑ > 1" •I Description:

Setbacks N/A~ Floor: Debris: Q No Visible/Fine Layer ❑ 3 to 1" 0> 1" Floor. Debris: Q No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: Q No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: Q No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: Q No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: L /2002 Inspection Team: Name t- t- LuJic ( 'Agency: C t n Name: Agency: R

NYC-WTC-000118056