WTC inspection form, 11 Jay Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form I n C0(, (4 Premise Address:

Block: q o Residentia Commercial Name of Building: itt Lot " o Mix UseD Other fl g of Stories: AKA's: Building Owner/Management Telephone Number ( ) Name: I k S 1 ST, 0 u. i ~ z- cam ' • FAX: Address: 1 l SA - - (00t3 Z `f On Site Contact: Name: ' ' S Telephone Number. Building Owner Management Activities Interior Survey Performed HYes8No Exterior Survey Performed Yes No d General Clean Up Yes No Locations: ACM Clean Up g Yes No Locations: Air Monitoring ❑ Yes 9 No Locations: Copies of All Reports and Data Requested JJ Yes

Visual inspection Results: Facade: Inspects Debris North N/A Yes No ble/Fine Layer 3% to 1" > 1" South N/A Yes No ble/Fine Layer '% to 1' > 1" East N/A Yes No ble/Fine Layer % to 1 wfl ) 1. West N/A Yes o Visible/Fipe Layer % to 1' H3101" Facade Description: F k.l lL

Roof

Debris: il0 /Fine Layer ._] 3% to 1 E] > 1' Description:

Setbacks N/AD Floor — . Debris: No Visible/Fine Layer 34 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. Floor___ Debris: No Visible/Fine Layer 34 to 1' > 1' Comments

Date: Inspection Team: Name:_- ~' / Agency: Name: Agency: ENTERS

NYC-WTC 000094097