WTC inspection form, 16 HUDSON STREET, BIN 1077399

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ! I ~'`~ Block: Residential Commercia .. Name of Building:, ( Lot: Mix Use jOther # of Stories: AKA's: - 2 (L( -/ / -11(0 Building Owner/Management: telephone Number. ( ) l5 Name: ( k r c1 0 `b AX: Address: &4 - 2 On Site Contac Name: • * .- l q' Telephone Number. Building Owner Man gement Activities Interior Survey Performed ❑ Yes [ lo Exterior Survey Performed 9 Yes [No General Clean Up ❑ Yes J No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested 9 Yes

Visual Inspection Results: Facade: Inspected De rIs North ❑ N/A Yes ❑ No No Visible/Fine Layer 934t01' 0>1 "

South ❑ N/A Yes ❑ No o Visible/Fine Layer ❑ 34 to 1" ❑ > 1" East ❑ N/A Yes ❑ No No Visible/Fine Layer 0%to 1" 0>1' West N/A Yes ❑ No o Visible/Fine Layer 0 1/2 `o 1" 1:J >1" Facade Description:

Roof

Debris: Visible /Fine Layer .❑ 34 to 1" 9>1" Description:

Setbacks N/A0 Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 03410 V ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ i4 to V 9> 1" Comments

Date: /2002 Inspection Team: Name: ~ Agency: F R Name: Agency:_______

NYC-WTC 000092742