Asbestos inspection form, 25 Broadway, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: S I

Block: Residential 0 Comm iaf Name of Building: Lot: Mix Use ❑ Other # of Stories:2 AKA's: L__ 1 o ' LJ Building Owner/Manage¢1ent: Telephone Number: (zx't) 2,4L-- .2-0 yS Name: .r" * ~ " FAX: ( ) Address: On Site Conta :i Name: ^ Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed 12ces ❑ No Exterior Survey Performe es ❑ No General Clean Up j es . No Locations: ACM Clean Up _ ❑ Yes No Locations: Air Monitoring AYes ❑ 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 ❑ % to 1" ❑ > 1" South NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" East ❑ N/A aYes ❑ No E'No Visible/Fine Layer ❑'/ to 1" ❑ > 1" West ❑ N/A 'R Yes ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description:

Roof

Debris: Visible /Fine Layer ❑ Y2 to 1" •1 -4 "~ [3> 1" 1 Description: \

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: n Z Debris: [[2ilo Visible/Fine Layer ❑ Y to 1" ❑ > 1" Floor: Debris: 9 No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1"

Comments / (,

Date: I//2002 Inspection Team: Name: Agency: C~ Name: Agency:

Ert `I ED

NYC-WTC 000123516