WTC Visual Survey Form
Premise Address:
114— i E6 Fv {..-TO is STREET
Block: r Residential O Commercial Name of Building:
Lot: `r Mix Use Other
# of Stories: AKA's:
Building Owner/Management C~DAcz Telephone Number. (zfz ) 732— 76s3
Name: z.tc."A2d> pvggL FAX:
Address: 2c> c,TIZEE T Nq
On Site Contact:
- 'tau sr
Name: - G u=t4 Telephone Number . P
Building Owner Management Activities
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes D No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested Yes
visual inspection Results:
Facade:
n pected Debris
North N/A Yes ❑ No ❑ No Visible/Fine Layer % to? ❑ > 1"
South N/A Yes O No ❑ No Visible/Fine Layer %a to? O> 1"
East tj N/A 'Yes [J No No Visible/Fine Layer ❑ V to 1" ❑ > 1"
West ❑ N/A J Yes D No No Visible/Fine Layer ® h to 1" ❑ > 1"
Facade Description:
Roof
Debris: ❑ No Visible /Fine Layer 14 to 1" '' j ❑ > 1"
Description:
Setbacks N/A D
Floor. 2to Debris: ❑ No Visible/Fine Layer 014 to? > 1"
Floor. Debris: ❑ No Visible/Fine Layer O14 to? > 1"
Floor____ Debris: ❑ No Visible/Fine Layer 014 to? O>?
Floor. Debris: ❑ No Visible/Fine Layer 014 to? ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer 014 to? O>?
I Comments
Date: Oc i11 /2002 Inspection Team: Name: DA/Ao20 Agency: WC t P
Name: Agency:
NYC-WTC 000128880
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000128880Source: NYC Law Department, mirrored locally
A Department of Environmental Protection form recording facade and ACM inspection results for a building at 292 Greenwich Street dated February 12, 2002.