DEP letter requesting environmental data for 115 Chambers Street, Feb

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: / Residential Commercial Name of Building: * G 3 Lot: Mix Use El Other # of Stories p AKA's: _._._._._._._._..........._._._._._._._._._._._._._._._._._. Building O n / nagement: Telephone Number:; II Name: e_ FAX: Address: On Site Co ct: II Name: era o~-8 ~-e.,~~ 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 El No Locations: Conies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer El 1/2 to 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ '/2 to 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ '/2 to I" Facade Description:

I Roof Debris: Visible /Fine Layer ❑ '/2 to I" ❑ > 1" "" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to I" ❑ > 1"

Comments —r ~~ ~ - ILo

Date: ( / /2002 Inspection Team: Name: _-Lu,u. Agency: ~' Name: i— Agency: t O-t-

t NYC-WTC 000121880