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WTC inspection form for 180 Broadway

Machine-extracted title · confidence 90%

Form documenting building details and inspection results for asbestos-containing materials and air monitoring at 180 Broadway.

NYC-WTC_000122838–000122841

Folder label: “180 BROADWAY 1001101, 65/18

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Scanned page image, NYC-WTC_000122838
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NYC 9/11 Public Portal Document

WTC Visual Survey Form 100E(61 emise Address: Block: (p5 ResidentialD Commercial Name of Building: Lot: I 0 Mix Use Other # of Stories: AKA's: Building Owner/ anagement• Telephone Number: ( ) Name: FAX: Address: On Site Conpct: Name: * s Telephone Number: Building owner Management ctivities Interior Survey Performed fYes ❑ No Exterior Survey Perfo d '1es ❑ No General Clean Up BYes ❑ No Locations: ACM Clean Up ❑.-Yes ❑ No Locations: Air Monitoring B] 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 ❑ Y2 to 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" Facade Description:

Roof p)sti Debris: '1No Visible /Fine Layer ❑ % to 1" .1 ❑ > 1" ' Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: L1IS/2002 Inspection Team: Name: u -Agency: -r Name: _ Agency: V NYC-WTC 000122838

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NYC-WTC_000122838Source: NYC Law Department, mirrored locally

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