Asbestos inspection form, Battery Park Building

NYC 9/11 Public Portal Document WTC Visus! Sua a w Fnrm Premise Address: PW _ Block: Residential 0 Commercial Name of Building: Lot: Mix Use 0 Other # of Stories 2. AKA's: Building Owner/Management: Telephone Number. ( ) Name: m FAX: dress: 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 p Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer D%toi" ❑ " South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yto1 1 w ❑ >1w East ❑ N/A ❑ Yes ❑ No O No Visible/Fine Layer ❑ '%2 to l" 0>1" West ( 'N/A ayes ❑ No No Visible/F"in€ay er ❑%2tol" ❑>1" Facade Description:

Roof

Debris: No Visible /Fine Layer ❑ % to 1" 0>1" Description:

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer 0 f to 1" D> 1" Floor. Debris: No Visible/Fine Layer 0 % to 1" ❑ > 1" Floor: Debris: [J No Visible/Fine Layer ❑ Y., to 1" ❑ > 1" Floor: Debris:[❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: 'P7 i 712002 T Inspection Team: Name: Name: . S 't 4 : 1 envy: Agency: f

NYC-WTC 000119422