Block: Residential Commercial Na of Bulidl"~"
Lot: I Mix Use Other i .,, V`~~
# of Sto es: AKA's:
Building Owner/Management Telephone Number. ( )
Name: FAX:
Address:
On Site Contact:
Name: ' Telephone Number.
Building Owner Management Activities
Interior Survey Performed Yes No
Exterior Survey Performed Yes B 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 Results:
Facade:
In cted Debris
North ❑ /A fY e ❑ No ❑ No Visible/Fine Layer i4 to T, >V
South No i] No Vsible/Fine Layer i%to T, > 1"
East N/A No No Vsible/Fine Layer %to 1' V
West ❑ N/A 0 No No Visible/Fine Layer H%toll ❑ > 1"
Facade Description:
Roof
Debris: Visible /Fine Layer fl 34 to 1" 0>1'
Description:
Setbacks N/A ❑
Floor
Floor
Floor.
Debris: 9 No Visible/Fine Layer
Debris: Visible/Fine Layer
Debris: [] No Visible/Fine Layer
014
1 to 1"
to 1"
14 to 1"
0>1'
fl '?
0>1'
Floor Debris: ❑ No Visible/Fine Layer 14 to 1" 0>1'
Floor. Debris: [] No Visible/Fine Layer 14 to 1" El'?
Comments
a
Date: "1 / /2002 inspection Team: Name: Agency:
ENT ERED Name: Agency:
NYC-WTC 000129061
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000129061Source: NYC Law Department, mirrored locally