WTC Visual Survey Form
Premise Address: Il
Block: Residefitial 0 Commercial f Name of Building:
Lot: Mix Use J J Other
# of Stories: f 1-+l AKA's:
Building Owner/Managenie t: Telephone Number: (•yt,
Name: 0 t0 fl Z,w ~t-e`a ,rs S4AX:
Address:
On Site Contactp •
Name: U.L ~4.eoF' Telephone Number.
Building Owner Management Activities
Interior Survey Performed Yes ❑ No
Exterior Survey Performed [DYes ❑ No
General Clean Up [2 Yes ❑ No Locations:
ACM Clean Up Eyes ❑ No Locations:
Air Monitoring Q'Yes ❑ No Locations:
Copies of All Reports and Data Requested
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 034t01" 0>1"
South ❑ N/A D Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 034to1" 0>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑34to1" 0>1"
Facade Descnption:
Roof
Debris: ' No Visible /Fine Layer ❑ % to 1" 0>1"
Description:
Setbacks N/A ❑
Floor: Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1"'
Floor: Debris: ❑ No Visible/Fine Layer 0 % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ a to 1" Q > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Comments
WTC debris inspection form documenting visual inspection results for facade condition, ACM assessment, and building characteristics for a 3-story structure.
DEP inspection form for 50 Broadway documenting building characteristics, facade conditions, and asbestos-containing material survey across multiple building faces.