Asbestos inspection report form, WTC site

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: sv' (3.,0i4 ,,4 Block: Residential Commercial Name of Building: Lot: Mix Use EJ Other # of Stories: 3 AKA's: Building Owner/Management: Telephone Number: (Zr. ) Gig - to 6 F Name: 4 , 7r. f A e^ I t FAX: Address: So € €4 On Site Contact: Name: vh u f Cc' fl lc4 h. Telephone Number: (Z - ) ((1- ,cc Building Owner Managemerft Activi ies Interior Survey Performed ® Yes ❑ No Exterior Survey Performed ] Yes ❑ No . General Clean Up ® Yes ❑ No Locations: Co L c,- .e r , ACM Clean Up ❑ Yes ❑ No Locations: f AAR,,1 of h•vj ,- Air Monitoring © Yes ❑ No Locations: G Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected De North ❑ N/A 3Yes0No ® i ' Fine Layer E]'/2 to 1" 0>1" South ❑ N/A J Yes ❑ No e/Fine Layer ❑ 1/2 to 1" 0>1" East ❑ N/A Yes ❑ No isi ine Layer ❑Y2 to 1" 0>1" West ❑ N/A [KYes ❑ No o bl ine Layer ❑'/2to1" 0>1" Facade Description:

Roof

Debris: o Visible ine ayer 0'/2 to 1" ? ~'' ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: t No Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: 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 ❑ % to 1" ❑ > 1"

Comments

Date: 2 Y/2002 Inspection Team: Name: / ' _i9 h d #P14'c 2 t Agency: Name: Agency:

NYC-WTC 000123362