WTC environmental hazard assessment form, 49 Broadway

NYC 9/11 Public Portal Document

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WTC Visual Survey Form Premise Address: 4 T rj '-✓~Y Block: Residential 0 Commercial jj Name of Building: Lot: Mix UseD Other d Cl'- -# of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: / FAX: Address: On Site Contact Name: c Telephone Number. 2/t..) Zs— Building Owner Management Activities Interior Survey Performed Q Yes Q No Exterior Survey Performed Q Yes Q No General Clean Up Q Yes Q No Locations: ACM Clean Up Q Yes Q No Locations: Air Monitoring Q Yes Q No Locations: Copies of All Reports and Data Requested DYes

Visual Inspection Results: Facade: Inspected Debris North Q N/A ❑ Yes Q No ❑ No Visible/Fine Layer 934 to 1" 0>1" South ❑ N/A ❑ Yes 9 No ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" East ❑ N/A ❑ Yes 0 No 0 No Visible/Fine Layer 34 to 1" ❑ > 1" West ❑ N/A Q Yes Q No ❑ No Visible/Fine Layer H%tol" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ] % to 1" 9>1" Description:

Setbacks WA ❑ Floor. Debris: Q No Visible/Fine Layer ❑ % to V >1" Floor. Debris: No Visible/Fine Layer ❑ % to V >1" Floor. Debris: E] No Visible/Fine Layer 934 to ? ~>l " Floor. Debris: 9 No Visible/Fine Layer ❑ % to ? ❑ >1" Floor. Debris: ❑ No Visible/Fine Layer Q 34 to V ❑ > 1"

Comments

Date: 3 I-3 2002 Inspection Team: Name: R A-/di't-t, Nnr✓ Agency: .1 Name: Agency: ENTERED

NYC-WTC 000118096