Asbestos inspection form, 25 Broadway, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: -S l '~~

Block: Residential 0 Comm i Name of Building: Lot: Mix Use ❑ Other # of Stories:> > AKA's: L l__ o- ' ---' '--- Building Owner/Manage ent: Telephone Number: ; P11 Name: ~~.1.r~ ~7Q' " FAX: ( ) ---------- Address: On Site Conta •l Name: ^'- ' Cr - Telephone Number: ( Building Owner Management Activities Interior Survey Perlormed es ❑ No Exterior Survey Performe es ❑ No General Clean Up (les No Locations: ACM Clean Up - DYes. No Locations: Air Monitoring 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 ❑ V to 1" ❑ > 1" South mod\ /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" East ❑ N/A fa Yes ❑ No No Visible/Fine Layer ❑'/ to 1" ❑ > 1" West ❑ N/A JRYes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description:

Roof ~~st Debris: No Visible /Fine Layer ❑ % to 1"-1 -A" O>1" 1 Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: — Debris: f to Visible/Fine Layer V O to 1" ❑ > 1" Floor: Debris: (] No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" E]> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" E)> 1"

Comments f f j (

Date: I / 12002 Inspection Team: Name: t-El) rvvt. Agency: C 6~ Name: Agency:

E Nt "?EI

NYC-WTC 000123516