DEP letter requesting environmental assessments, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form fOO12 z Premise Address: tz q t,ror& 5 C r

Block: J esidentiafD Commercial 0 Name of Building: Lot: 1 Mix Use ❑ Oth r ❑ # of Stories: AKA's: 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 ❑ Yes

Visual Inspection Results: Facade: Inspected bris North ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑'/2to1" 0>1" South ❑ N/A ❑ Yes ❑ No EJl No Visible/Fine Layer 0 14 to 1" 0>1" East ❑ N/A ❑ Yes ❑ No EJj No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑'Y2to1" ❑>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer )< / to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

Date: / 002 Inspection by: Name: Agency: .Y Name: Agency:

NYC-WTC 000119455