NYC 9/11 Public Portal Document
WTC Visual Survey Form 10z33S3
• ►'rirnise Address:
Block: g Residential Commercial 0 Name of Building:
Lot: Mix Use 9 Other
# of Stories: AKA's:
Building Owner/Management:Sow. ,14 1fli,t Telephone Number. ( 2.12-) =6-i- bl90
Name: Torj 4o. FAX:
Address:
On Site Contact
Name: •A 'e c,~€r /K'ha..,, ,4+4 S, Telephone Number:
Building Owner Manadement Activities
Interior Survey Performed [] Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up EYes ❑ No Locations: voJ.-,
ACM Clean Up ❑Yes ❑ No Locations:
Air Monitoring j$'Yes j] No Locations: vacvt.'s
Copies of All Reports and Data Re uested Yes
visual inspection Kesuits:
Facade:
Inspected Debris
North [] N/A EYes ❑ No j~'No Visible/Fine Layer p/ato1" 9>1"
South ❑ N/A OYes ❑ No j No Visible/ etaydr 034t01" 0>1"
East ❑ N/A 0 Yes ❑ No ® No ViSible/Pini=tayer 034t01" 0>1"
West ❑ N/A 'Yes ❑ No No Visible/FM-Liyeer []%to1" 0>1"
Facade Description:
Roof
Debris: Ig No Visible /Fine-Eager to 1" 9>1"
Description:
Setbacks N/A 0 •
Floor: Debris: 0 No Visible/Fine Layer (] % to 1" 0>1"
Floor: Debris: 0 No Visible/Fine Layer '4 to 1" 0> 1"
Floor: • Debris: ❑ No Visible/Fine Layer ❑ h to 1" 0> 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to V ❑ > 1"
Floor. Debris: 0 No Visible/Fine Layer ❑ 4 to 1" 9>1"
Comments
Date: Z /14/2002 Inspection Team: Name: Agency: N C DEP•
Name: Agency:
NYC-WTC 000129362
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