Asbestos inspection form for 114-120 Greenwich Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form r ,

Premise Address: ✓~

Block: 15 Residential 0 Commercial Name of Building: Lot: Mix Use J Other # of Stories: AKA's: C,2 Building Owne n amen Telephone Number: Name: Address: On Site Contact: Name: * ' Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes` No Exterior Survey Performed ❑ Yes o General Clean Up, es ❑ No Locations: ACM Clean Up ❑ Yes [ to Locations: Air Monitoring ❑ Yes ( No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Kesuns: Facade: Inspected Debris North l/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yato1" ❑>1" South /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" East [ ] N/A es ❑ No ❑ No Visible/Fine Layer ❑Y2 to 1" 0>1" West N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" Facade De np i n:

Roof Debris: Visible /Fine Layer F]% to 1" 0>1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/s to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1"

Comments qj A f -r i

Date: / 002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000128616