NYC 9/11 Public Portal Document
WTC Visual Survey Form
Premise Address:
9z chamber S1 e *
Block: Residential Commercial j Name of Building:
Lot: Mix Use Other
# of Stories: AKA's:
Building Owner/Management: HambeY'er 4r.n Xi*rTelephone Number: (- j2) '& 7_ /a?c
Name: M. FAX: ( )
Address: 3l S:31 f n -e-
An+~er
On Site Contact: The Iau.ret~t
Name: Telephone Number:
Building Owner Management Activities
Interior Survey Performed Q Yes Q No
Exterior Survey Performed Q Yes Q No
General Clean Up ❑ Yes Q No Locations:
ACM Clean Up ❑ Yes Q No Locations:
Air Monitoring Q Yes Q No Locations:
Copies of All Reports and Data Requested DYes
Visual Inspection KesuI :
Facade:
Inspected Debris
North ❑ N/A [Yes ❑ No No Visible/Fine Layer ❑'% to 1" ❑ > 1"
South ❑ N/A Q Yes Q No ENoVisiblefFine Layer ❑ % to 1" 0>1'
East ❑ N/A Q Yes Q No ❑ No Visible/Fine Layer Q'/ to 1" ❑ > 1"
West ❑ N/A Q Yes Q No Q No Visible/Fine Layer_ 0 Y to 1" 0>1"
Facade Description:
Roof
Debris: ISNo-Visible /Fine Layer 12 Y2 to 1" 0> 1"
Description: i," fui ]/ ke AA?-%,r r.z -,s a.,d W. e ewrj
Setbacks N/A
Floor: Debris: Q No Visible/Fine Layer ❑'/2 to 1" 0> 1"
Floor: Debris: Q No Visible/Fine Layer ❑'/s to 1" ❑ > 1"
Floor: Debris: Q No Visible/Fine Layer 0% to 1" ❑ > 1"
Floor. Debris: Q No Visible/Fine Layer Q'/ to 1" 0> 1"
Floor. Debris: Q No Visible/Fine Layer Q'h to 1" 9 >V
Comments
.ti.2 Ya ccrr, •:C> a tt✓nri. /Vo ccr~cld.
Date: C//_4/2002 Inspection Team: Name: R. Agency: USEPA
Name: Agency: ^NYC .DEP
NYC-WTC 000122118
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