WTC inspection form, 14 Jay Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form toOi5S1 remise Address: ~.—

Block: f Residential Commercial JJ Name of Building: Lot: t) Mix Use 9 Other # of Stories: AKA's: Building er/Mana ement Telephone Number. ( ) Name: CCU?• FAX: Address: On Site Contac • Name: " " Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed [] Yes a No General Clean Up Yes No Locations: 3 ACM Clean Up Yes No Locations: Air Monitoring 9 Yes r] No Locations: Copies of All Reports and Data Requested p Yes

Visual Inspection Results: Facade: Ins cted Debris North [] N/A ❑ No QJo Visible/Fine Layer % to 1' 9>1' South [] N/A Yes Q No No Visible/Fine Layer %to 1' >1' East N/A Yes 9 No No Visible/Fine Layer % to 1' '1' West N/A Yes No No Visible/Fine Layer H%tol , >1' Facade Description:

Roof

Debris: .0 No Visible /Fine Layer L7 36 to 1" 9>1'

Setbacks NIAf Floor.___ . Debris: No Visible/Fine Layer % to 1' >1' Floor Debris: No Visible/Fine Layer 36 to 1' >1' Floor.___ Debris: No Visible/Fine Layer % to V >1' Floor. Debris: No Visible/Fine Layer % to 1' >1' Floor.___ Debris: No Visible/Fine Layer % to 1' >1'

Comments

Date: / / f_ ,~. N T E 12002 Inspection Team: Name: Name: (— Agency: Agency:

NYC-WTC 000094105