WTC inspection form, 18 Jay Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: -1 Block:Jf 3 Residential Co mercial Name of Building: Lot.. Mix LlsejJ OtherjJ # of Stories: AKA's: Building OwneIlManagement Telephone Number. ( ) Name: FAX:( K 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 9 Yes ❑ No Locations: Copies of All Reports and Data Requested DYes t Visual Inspection Results: Facade: lnpected Debris North D N/A Yes No Ysible/Fine Layer %to 1" 9>1' South ]] N/A Yes No No Visible/Fine Layer 1' East N/A Yes No No Visible/Fine Layer %to

al' West N/A Yes No No Visible/Fine Layer E 34t01' 1' >1' Facade Description:

Roof Debris: Visible /Fine Layer ._] 34 to 1' 9>1' Description:

Setbacks N/A=] Floor Debris: No Visible/Fine Layer 36 to 1' > 1' Floor.____ Debris: No Visible/Fine Layer 36 to V > 1' 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 1' >1' Comments

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Date: / 11 12002 Inspection Team: Name: y_L Agency: Name: Agency: NTE R E

NYC-WTC 000094116