WTC building assessment form, facade inspection, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1 00 \ L4 Prarnisa•Address: D Block: Residential 0 Commercial l Name of Building: Lot: a, 3- Mix Use ❑ Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: ) 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 ❑ 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 ❑'Y2to1" ❑>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2 to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" Facade Description: ,-,. Gti

Roof ❑ > 1" ,1. Debris: ❑ No Visible /Fine U Y2 to 1" •9 c Description: No Rs

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

Date: I) /2002 Inspection Team: Name: T Agency: Name: Agency: I NYC-WTC 000094374