Block: Residential Commercial Name of Building:
Lot: Mix Use J Other
# of Stories: AKA's:
Building Owner/Management: Telephone Number; P11
Name: FAX: (
Address:
On Site Contact:
Name: I Telephone Number: ()1 ) 'j 3 L— O-).7
Building dwner Management Activities
Interior Survey Performed []Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up 'Yes ❑ No Locations:
ACM Clean Up ❑ Yes~"Ao Locations:
Air Monitoring ❑ YesPo Locations:
Copies of All Reports and Data Requested El Yes
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1"
Facade Description: a ()
Roof
Debris: No Visible /Fine Layer ❑ Y2 to 1" ❑ > 1"
Description:
Setbacks N/Ax
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1"
Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" [2>1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" [2 >1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1"
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 292 Greenwich Street dated February 12, 2002.