PAGE 1 OF
ASBESTOS INSPECTION REPORT
DATE
STREET
REMISE NQ QQ
i `O Pr u t "
SQUAD r BADGE
BLOCK LOT
ZIP BORO CODE
o ~3 1 D lD
~9* P110106 TAKEN. YES ! NO
p ~•- BLDG TYPE BASIS OF INSPECT ,O , 0 ~d -
SAMPLE NL~O.
ONTRACTORS NAME t
t_ SAMPLE NO.
CITY tw
A A
DRES O C?
_ SAMPLE NO.
ZIP t PHON
STATE 3
N O ERS N ME
LABO A RYNAME_ ~ £ ~ P
L ITY
CITY AD RESS
AD~pE ç1 {~ S s N ~1
STATE 1 ZIP PHONE
STATE t ZIP
Ig a
N
CONTACT PERSON:
TIME OF INSPECTION FROM: 3 p am~m' TO'
B <6 Stories C Single Family
BLDG TYPE A > 6 Stories .
E 4-lospital F Public Owned Property
D School
RESULT CODES I - Violation issued 2 - $ o Violations Issued 3 - No Access
309.
4 - Project not Started (No NOV) 5 - Project Completed (No NOV) ACP
FILE
NYC-WTC 000122641
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000122641Source: NYC Law Department, mirrored locally