WTC facade inspection form, 10 Jay Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form i(O1)1 (o Premise Address:

Block: t4 3 Residential ComrnerciallJ Name of Building: Lot: 7o ► Mix UseD Other # of Stories: AKA's: -" — Building Owner/Management: Telephone Number. ( ) Name: T)ufN E V e N'.LI t _ e5 NC, FAX: Address: oo On Site Contact: Name: ' ." /' Telephone Number. t Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No it Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes [] No Locations: 7 Air Monitoring r] Yes 0 No Locations: Copies of All Reports and Data Requested[]Yes

Visual Inspection Results: Facade: In acted Oe rls North E] N/A ØYes ❑ No o Visible/Fine Layer ❑ 34 to 1" L] > 1" 4 South 9N/A Yes ❑ No ❑ No Visible/Fine Layer ❑ 34 to 1" 0>1. East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 934 to 1" [J> 1' West ❑ N/A L] Yes ❑ No ❑ No Visible/Fine Layer L] 34 to 1" 9>10 Facade Description:

Roof

Debris: No Visible /Fine Layer .934 to 1' 9 > 1" Description:0

Setbacks N/A=J Floor.____ . Debris:D No Visible/Fine 3% to 1' 9 > 10 Floor____ Debris: ❑ No Visible/Fine Layer LayerE%tola > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ 36 to 1 > 1" Floor____ Debris: 0 No Visible/Fine Layer >10 Floor. Debris: 0 No Visible/Fine Layer 8 % to 1' 3.4 to 1" >10

Comments

Date: Inspection Team: Name: Agency: N 7 ~. R E *lame: Agency: -

NYC-WTC 000092816