WTC Visual Survey Form -* 10o12Z 1
Premise Address:
00a -Bro C-3 Ci W
Block: ? 0 CommercialD J Name of Building:
Residential
Lot: l q Mix Use ❑ 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 ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested ❑ Yes
Visual inspection Kesults:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to l" 0>1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1"
West ❑ N/A ❑ Yes ❑No ❑ No Visible/Fine Layer % to 1" ❑ > 1"
Facade Description:
A&A,&A-
Roof
Debris: ❑ No Visible /Fine Layer ❑ % to 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 ❑ % to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor Debris: ❑ No Visible/Fine Layer ❑ h to 1" ❑ > 1"
Comments
Date: O) / 15 /2002 Inspection by: Name: AP Agency: DEP
V Name: Agency:
NYC-WTC-000123246
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000123246Source: NYC Law Department, mirrored locally
Checklist form documenting building characteristics, facade visual inspection results, and asbestos presence assessment at 196 Broadway for post-9/11 environmental evaluation.
4 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.994
Joint memorandum from NYC DEP and DOH advising building owners on post-9/11 maintenance, re-occupancy issues, and hazardous material assessments including asbestos.