DEP letter requesting hazard assessments, 111 Chambers Street, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: (I uCvt Block: Residential D Commercial Name of Building: Lot: Mix Use fl Other # of Stories: AKA's: Building Owner anagement: 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 Q Yes

Visual Inspection Results: Facade: Inspected Debris North M N/A Q Yes ❑ No 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Facade Description: ' ►~Ct'Ct r Dc M t r

Roof

Debris: Q No Visible /Fine Layer ❑ % to 1" ❑ > 1" Description: ) L (CC) 1t Y" r

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

Comments

Date:./ a 6 /2002 Inspection Team: Name: l4L Agency: Name: Ho~2Fou Agency: Doc - A4(-f 3o NYC-WTC 000122004