WTC Visual Survey Form
Premise Address:
114 — 1(6 Fo -ro is S T2EET
Block: r Residential O Commercial U Name of Building:
Lot: 4 'r Mix Use Other
# of Stories: AKA's:
Building Owner/Management c1rz n arr Telephone Number. (wiz ) -r32-T S3
Name: t≥.icitngn w8eL FAX:
Address: tea E"' STREET NY .-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.
On Site Contact: T&s> SOPT II
Name: * -Cx Lrat4 Telephone Numb
Building Owner Management Activities ---------------------------------------------------
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes[] 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 f j Yes
visual inspection Results:
Facade:
n pected Debris
North N/A YesD No Q No Visible/Fine Layer '/z to 1" ❑ > 1"- -
South N/A iYes ❑ No ❑ No Visible/Fine Layer 'h to? ❑ > 1"
East fl N/A 'Yes ❑ No No Visible/Fine Layer ❑ % to? J > 1"
West ❑ N/A Yes ❑ No j No Visible/Fine Layer ❑ 2 to 1" O>1'
Facade Description:
Roof K
Debris: ❑ No Visible /Fine Layer 0/2 to 1' '' ❑ > 1'
Description:
4
Setbacks N/A ❑
Floor: 2+sc Debris: Q No Visible/Fine Layer [I a to 1" > 1"
t Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to? > 1"
t Floor. Debris: ❑ No Visible/Fine Layer O a to 1" ❑ > 1'
Floor. Debris: ❑ No Visible/Fine Layer ❑ r6 to 1" O> 1"
Floor: Debris: O No Visible/Fine Layer ❑ i4 to 1' O>1'
Comments
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 292 Greenwich Street dated February 12, 2002.