Asbestos inspection report form, 23 Chatham Square, Oct 2001

NYC 9/11 Public Portal Document

t, WTC Visual Survey Form Premise Address: e-- C. Block: Residential Commercials Name of Building: Lot: 1 Mix Use Other fl # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact Name: ' * .. . Telephone Number: Building Owner Management Activities Interior Survey Performed Yes No Exterior Survey Performed [] YesH No General Clean Up Yes No Locations: ACM Clean Up Yes No Locations: Air Monitoring ❑ Yes No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North South Q N/A N/A DYesONo 0 Yes ❑ No o No Visible/Fine Layer No ViSible/Fine Layer 34 to 1' 34 to 1' J>1' 0>1' fl East N/A DYesDNo No Visible/Fine Layer %to 1' 0>1' West J NIA [] Yerp No ❑ PA Visible/Fine Layer ❑ i4 to 1' 0>1' Facade Description: r

I Roof

Debris: [ b Visible !Fine Layer .9 34 t01' 0>? Description:

, Setbacks N/A [ Floor____ Debris: 0 No Visible/Fine Layer ❑ y4 to 1' ❑ > 1' Floor____ Debris: ❑ No Visible/Fine Layer 034 to? ❑ > 1' Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' Floor___ Floor Floor Debris: No Visible/Fine Layer D4 to V Debris: g No Visible/Fine Layer ❑ i4 to V J> ❑ > 1'

0> 1' 1' Comments

-f: inspection Team: Name: ~- Agency: Name: Agency:

NYC-WTC 000126956