WTC inspection form, 18 Jay Street, Oct 2002

NYC 9/11 Public Portal Document

v WTC Visual Survey Form /Q7c'/79 Premise Address: of Block: 3 Residential . Com rcia Name of Building: wia- Lot 76o Mix Use El OtherjJ # of Stories: 3 AKA's: Building Owner/Management Telephone Number. ( ) Name: I FAX:( Address: On Site Con ct: 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 D Yes t] No Locations: Copies of All Reports and Data Requested Yes t Visual lnscection Results: Facade: i

Ins acted . Debris North D NIA :] No o Visible/Fine Layer % to 1' 9>1' South [] N/A Yes [] No No Visible/Fine Layer % to 1' i

> 1' East West H N/A NIA Facade Description: Yes No Yes No No Visible/Fine Layer No Visible/Fine Layer H i4 to 1' 34 to l ' >1' >1'

Roof Debris: Visible /Fine Layer .I]% to 1' 9>1 Description:

Setbacks I4/AO Floor___ . Debris: No Visible/Fine Layer 14 to 1' >1' 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 34101' >1' Floor.___ Debris: No Visible/Fine Layer 14 to 1' >1' Comments

Date: l 1 ( 12OQ2 inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000094114