Asbestos inspection form for 96 Chambers Street, DEP Box 49

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential Commercial J Name of Building: Lot: Mix Use O Other # 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 Q 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 Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" ❑N/A es ❑ No ❑ No Visible/Fine Layer ❑ % to 1" -'r 1" asF ❑ N/A O[ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" Q> 1" West O N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Va to 1" 0>1' Facade Description: '~,r~ < ~ij1Y►R411/j am [ ccLL V

Roof

Debris: [No Visible IFineI.ayer ❑ % to 1" .1 = ❑ > 1" 1 '' Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: (] No Visible/Fine Layer 0 V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑V:to 1" ❑ > 1" Floor: Debris: [] No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ] > 1" Comments

Date: / 2002 Inspection Team: Name: -- Agency: 03 8 31 N 3 Name: Agency:

NYC-WTC 000122200