Premise Address:
a t' c1<M(4 Z
Block: Residential 0 CommercialD Name of Building:
Lot: Mix Use J Other0
# of Stories: AKA's: 7 0 J . L t_ i k.
Building Owner/Management: Telephone Number ( )
Name: FAX:
Address:
On Site Contact:
Name: Telephone Number: )
Building Owner Management Activities
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes (] No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested J Yes
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer '/ to 1" 0>1"
South ❑ N/A []Yes ❑ No ❑ No Visible/Fine Layer '/to1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer '/to1" 0>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer %to1" ❑>1"
Facade Description:
Roof
Debris: [ No Visible /Fine Layer ❑ % to 1" ❑ > 1"
Description:
Setbacks N/A ❑
Floor Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'!to 1" ❑ > 1"
Comments
Date: I t 5 /2002 Inspection by: Name: (, . Agency: N C O
Name: Agency:
NYC-WTC-000118845
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000118845Source: 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.