WTC Site Record ID 000093286 form, Oct 2001

NYC 9/11 Public Portal Document

loo1ug3 WTC Visual Survey Form Premise Address: 3 Uo n Tree -~ Block Residential El Commercial Name of Building: Lot: Mix Use EL Other ❑ # of Stories: AKA's: Building Owner/Management: 4/si I S2 I W Telephone Number: ( ) tom 54 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 ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected De ris North ❑ N/A ❑ Yes ❑ No rj'Jo Visible/Fine Layer ❑ % to 1" 0>1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑'/ to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑'/ to 1" ❑>1" Facade Description:

Debris: No Visible /Fine Layer ❑%to 1" ❑> 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

• 11 11 = 1 ►_

Date: /1(/2002 Inspection by: Name: Al' Agency: DE P 7 Name: Agency:

NYC-WTC 000093289