Block: I Residerfti l 0 Commerciaçf Name of Building:
Lot: I Mix Use'EJ Other
# of Stories: AKA's:
Building wner/Mane er ent: J ,L Telephone Number: (2 c L) (j
Name: ~U t ►~ 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: U•\/\ Qk I
ACM Clean Up ❑ Yes ,4Zo Locations: -
Air Monitoring es ❑ No Locations:
Copse of All Re orts and Data Re uested es
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A es ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1"
South ❑ N/A Yes ❑ No No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
East ❑ N/A Yes ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1"
West ❑ NIA Yes ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Facade Description:
Ott
Roof
Debris: Visible /Fine ayer ❑Y2 to 1" ❑> 14=
Description:
o.
Setbacks N/A, ._..
Floor: Debris: ❑ No Visible/Fine Layer ❑'/% to 1" ❑ > 1"
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 ❑'/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ %2 to 1" ❑ > 1"
Comments
Date: ~_/ /2002 Inspection Team: Name: L 4'At c Agency:
Name: Agency:
NYC-WTC 000122461
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NYC-WTC_000122461Source: NYC Law Department, mirrored locally