Asbestos survey form, 150 Broadway, Oct 2001

NYC 9/11 Public Portal Document

seal Survey , Form 31 100t on rniSe Address'

Block: - Residential Commercial Name of Building: Lot: Mix Use ❑ Other ❑ # of tries: AKA's: Building OwnerlMangement: Telephone Number: ( ) Name. 3 . t ,. FAX Address: ~, ::: ~~ ....4 On Site Contact: Name: M . , <= io Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed Yes ❑ No Exterior Survey Performed f Yes ❑ No General Clean Up ❑'Yes ❑ No Locations: ACM Clean Up ❑Yes "No Locations: ..... "..:: Air Monitoring fjJ Yes ❑ No Locations: Copies of All Reports and Data Requested fYes

Visual Inspection Results: Facade: Inspected Debris F. . North ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1' South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer E11/2t0 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer [1 1/2 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1" Facade Description: Y. N 4..

(

Roof

Debris. lNo Visible /Fine ayer ❑ 1/z to 1" '1 " "'~ ❑ > 1" Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" [1 > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

,~ Date: 2 l /2002 Inspection Team: Name: ` i . ',rw t Agency? ' Name: Agency:

NYC-WTC 000122526