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WTC Visual Survey Form 1000039
r'_:.4'e Address: -
1' f v
Block: Residential 0 Name of Building:
-
CommerciaIa
Lot: Mix Use 0 Other fl
-W-of Stores: AKA's:
Building Owner/Mana eme t: Telephone Number. ( )
Name: FAX:
Address:
On Site Contact:
Name: Telephone Number:
Building Owner Managem t Activities
interior Survey Performed Yes ❑ No
Exterior Survey Performed ❑ Yes No
General Clean Up 0 Yes ❑ No Locations:
ACM Clean Up 0 Yes ❑ No Locations:
Air Monitoring j] Yes ❑ No Locations:
Copies of All Reports and Data Requested Yes
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A ❑Yes0No ❑ No ViSible/Fine Layer ❑%to1" 0>1"
South ❑ N/A ❑Yes[]No ❑ No VSible/Fine Layer ❑ h to 1" 0>1"
East ❑ N/A ❑ Yes ❑No ❑ No Visible/Fine Layer ❑34to1" 0>1"
West ❑ N/A ❑Yes,QNo ❑ No Visible/Fine Layer ❑Yato1" 0>1"
Facade Description:
Roof
Debris: '6 No Visible /Fine Layer 9% to 1" ❑ > 1"
Description:
Setbacks N/A~
Floor. Debris: ❑ No Visible/Fine Layer 034 to 1"
Floor. Debris: ❑ No Visible/Fine Layer 0 % to 1'
Floor: Debris: ❑ No Visible/Fine Layer 03410 V
Floor. Debris: 0 No Visible/Fine Layer 34 to 1'
Floor. Debris: ❑ No Visible/Fine Layer H 34 to 1"
Comments
Date: i 12002 Inspection Team: Name: Agency:
Name: Agency:
NYC-WTC-000118275
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000118275Source: NYC Law Department, mirrored locally
DEP inspection form for 50 Broadway documenting building characteristics, facade conditions, and asbestos-containing material survey across multiple building faces.