WTC debris inspection form, 10 Jay Street, Oct 2001

NYC 9/11 Public Portal Document

/. WTC Visual Survey Form . remise Address:

Block: 1 -

19 S -r' Name of Building: ~V Lot: Mix Use Other $ of Stories: AKA's: --(a & S 2E T Building Owne nagemg Telephone Number. Fes: P11 ,.._._._._._._ Name: ~~.~~. ~------ Address: PII On Site Contact: Name: ' ' Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes No Exterior Survey Performed ❑ Yes C] No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring D Yes ❑ No Locations: Copies of All Reports and Data Requested DYes

Visual Inspection Results: Facade: ins acted De s North ❑ NIA Yes D No Visible/Fine Layer 0% to 1 9>1' South Q N/A ❑YesONo TJ No Visible/Fine Layer ❑%to1' 9>1' East Q N/A []YesDNo No Visible/Fine Layer '/:to 1" 0>1' West [] N/A E]Yes0No No Visible/Fine Layer D34to 1' 9>1' Facade Description:

Roof

Debris: Visible !Fine Layer .L] 34 to 1' 9> 1' Description:

Setbacks N/A❑ Floor Debris: ❑ No Visible/Fine Layer 74 to 1' 9>1' Floor____ Debris: ❑ No Vi Visible/Fine Layer 0] % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer % to 1' > 1' Floor. Debris:D No Visible/Fine Layer 'A to 1' > 1' Floor.____ Debris:[] No Visible/Fine Layer 'A to 1' >1' Comments / ✓C a

Date: ) II 12002 Inspection Team: Name: i— f 1 ' Agency: Name: Agency: ENTEREtt

NYC-WTC 000092814