Asbestos inspection form, 25 Broadway, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: s 1 y Block: Residential J CommfiaF I Name of Building: Lot: Mix Use ❑ Other # of Stories:i AKA's: v, L Building Owner anage ent: Telephone Number: (2xL) ;y Zfl ;S Name: \f .-r FAX: Address: On Site Conta :) C; Name: LJAAfl \1' m'S*$'°' Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed V es ❑ No Exterior Survey Performe es ❑ No General Clean Up (les j J No Locations: ACM Clean Up . ❑ Yes. No Locations: Air Monitoring gYes ❑ 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 ❑'/z to 1" ❑ > 1" South N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1" East ❑ N/A OYes ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A JYes ❑ No [ No Visible/Fine Layer ❑ / to 1" ❑ > 1" Facade Description:

Roof

Debris: Visible /Fine ayer ❑ % to 1" •7 "`'~ ❑ > 1" ' •~ `'~ ' Description. \\

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: o Visible/Fine Layer ❑ Va to 1" Jo ❑ > 1" Floor: Debris: Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer fl 1/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments -, (,T -O' z j(

Date: I / /2002 Inspection Team: Name: ,A$: /K-fl I1(k.M +wt, Agency: t-"c Name: Agency:

NYC-WTC 000123515