WTC environmental inspection form for 16 Hudson Street

NYC 9/11 Public Portal Document

C' 77 3`7 7 WTC Visual Survey Form 3 _:r 5 Premise Address: . , ) e^J 1 t Block: I4L1 Residential 0 Commercial Narn of Bui g Lot: Mix UseD Other a k4 O # of Stories: AKA's: Building Owner/Management Telephone Number: 2 ti) < 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 [1Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Ins ected De s North ❑ N/A es ❑ No o Visible/Fine Layer ❑'%stol" ❑>1" South ❑ N/A ❑ Yes ❑ No Do Visible/Fine Layer ❑ ❑4to1" ❑>1" East ❑ N/A [des ❑ No Layer ❑'/to1" D>1" West ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" D>1 Facade Description:

Roof

Debris: ❑ No Visible /Fine ❑4to107 r]>1"

Description: !

Setbacks N/A ❑ Floor. Debris:F] No Visible/Fine Laye(❑ % to 1" Floor Debris: ❑ No Visible/Fine Layer ❑ Va to 1" Floor. Debris: ❑ No Visible/Fine Layer 0 % to V Floor. Debris: ❑ No Visible/Fine Layer ❑ 4 to 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 6 to V

Comments

Die Inspection Team: Name: Name: Agency:

NYC-WTC 000092749