WTC environmental inspection form, 67 Hudson Street, Oct 2001

NYC 9/11 Public Portal Document VYTC Visual Survey Form /nr?n4cc r Pr ise Address: 'Block: i i) Residents Commercial Name of Building: I Mix Use Other ~-4 ~MA~11 b # of Stories: AKA's: - a4 TiET Building Owçe/Pianagesnt Tel phone Number. ( ) Name: e o a Address: FAX: er a On Site Contact:. Name: ' ' .. Telephone Number. Building Owner Management Activities Interior Survey Performed 0 Yes D No Exterior Survey Performed Yes ❑ No General Clean Up Yes No Locations: ACM Clean Up E]Yes No Locations: Air Monitoring D Yes 0 No Locations: Copies of All Reports and Data Requested fl Y.s Visual tnsoection Results: Facade: Inspected . Debris North NIA 9 Yes No 9 No Visible/Fine % to 1' >1' South N/A Yes No No Visible/Fine Layer % to 1 >1. East N/A es No No Visible/Fine Layer 5 to 1' > 1' West NIA YesE] No Layer LayerH%tolo > 1' Facade Description: _

Roof Debris: o Visible /Fine Layer L]34 to 1' jJ > 1' Description:

Setbacks WA9 Floor.___ Debris: No Visible/Fine Layer % to 1' >1' Floor.__ Debris: No Visible/Fine Layer K to 1' > 1' Floor. Debris: No Visible/Fine Layer % to V > 1' Floor_ . Debris: No Visible/Fine Layer % to 1' > 1' Floor___ Debris: No Visible/Fine Layer )4 to1' > 1' Comments

Date: 12002 Inspection Team: Name: — Agency. !dame: Agency:

NYC-WTC 000092779