WTC Asbestos Inspection Form, 321 Greenwich Street

NYC 9111 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residentia - Commercial Name of Building: Lot: Mix Use Other JJ # of Stories: 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 ❑ 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 Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%ztol" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ a to l" 0>1" East ❑ N/A ❑ Yes Q No ❑ No Visible/Fine Layer ❑Ytol" 0>1" West ❑ N/A YesflNo Visible/Fine Layer ❑Yato l" 0>1" Facade Description:

Roof Debris: ( ] No Visible /Fine Layer ❑ % to 1" , ❑ > 1"

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ 14 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 14 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Cnmmnts 4,

Date: Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000134416