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← Document results/DEP Box 49/97 CHAMBERS ST 1001630, 149/12
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Asbestos inspection report form for unspecified premises

Machine-extracted title · confidence 100%

Blank or partially filled asbestos inspection report form used to record site details, contractor information, and sample numbers.

NYC-WTC_000122255–000122257

Folder label: “97 CHAMBERS ST 1001630, 149/12”

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Scanned page image, NYC-WTC_000122256
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: - -'~ Residential 0 ComrnerciaQ k'Jof Building: Block: Name Lot: Mix Use fl 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 n No General Clean Up Q Yes ❑ No Locations: ACM Clean Up ❑ Yes Q No Locations: Air Monitoring 9 Yes Q No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North 0 N/A 0 Yes ❑ No O No Visible/Fine Layer ❑%to1" 9>1 South ❑N/A es0No o Visible/Fine Layer %tot" D>1' East N/A J Yes No No Visible/Fine Layer % to 1' 0 > 1w West O N/A Yes 8 No No Visible/Fine Layer 36tol D>1" Facade Description:

Roof Debris: j] o Visible /Fine Laye to 1" 9>r Description: cam- t. w. ( a... _

Yt0 - ZC S

Setbacks N/A ❑ Floor___ Debris:9 No Visible/Fine Layer 0% to 1' 9>10 Floor. Debris:9 No Visible/Fine Layer 0 Va to 1' 9 ) 10 Floor___ Debris: No Visible/Fine Layer 0Va101 0>1' Floor____ Debris: ❑ No Visible/Fine Layer 0% to 1' > 1' Floor.___ Debris: ❑ No Visible/Fine Layer 9 % to 1' ] >1' Comments ( '

Date: / 12002 Inspection Team: Name: Agency: Name: Agency: ENTER E

NYC-WTC 000122256

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NYC-WTC_000122256Source: NYC Law Department, mirrored locally

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