WTC visual inspection form, Hanover Square, undated

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: vv~ Block: Residentia ommercialD Name f Building: Lot: Mix Use Other # of Stories• AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: ' - a "~ 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 Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" West ❑ N/A Q Yes ❑ No ❑ No Visible/Fine Layer Q½ to 1" J> 1" Facade Description:

Roof

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

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" 0>1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/z to 1" ❑>1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑>1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑>1"

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Date Inspection Team: Name: y • Agency: Name: Agency: ENTER E

NYC-WTC 000093534