NYC 9/11 Public Portal Document
WTG Visual Survey Form
Premise Address:
j22 FO LTO P STrZE T
Block: Residential 0 Commercial Name of Building:
Lot: Mix UseD Other
# of Stories: AKA's:
Building Owner/Management JM vD 0 T 2s Telephone Number. ( )
Name: IO pl AVE FAX:
Address:
On Site Contact m& Cg>t ' '? : A • PLUS$-I At--, '
Name: ' o / 4&. PL%m0 Telephone Number ~i2 5 —4232
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 D Yes
visual inspection Kesults:
Facade:
!n pected Debris
North ❑ N/A EYes ❑ No D.No Visible/Fine Layer h to 1" ❑ > 1"..
South ❑ N/A B Yes ❑ No J No Visible/Fine Layer A to 1" ❑ > 1"
East 0 N/A No Visible/Fine Layer ❑'/% to 1' ❑ > 1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 2 to 1' 0>1"
Facade Description:
Roof
Debris: ❑ No Visible /Fine Layer ,'/s to 1" '' ❑ > 1"
Description:
Setbacks N/A ❑
Floor 3 +-c Debris: ❑ No Visible/Fine Layer }4 to 1" 0>1"
Floor. Debris: ❑ No Visible/Fine Layer D4 to 1" ❑ > 1'
Floor. Debris: 0 No Visible/Fine Layer ❑ h to 1' ❑ > 1'
Floor. Debris: No Visible/Fine Layer ❑ ,4 to 1"
r] ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0> 1"
I Comments
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