WTC building exterior assessment form, 2002

NYC 9/11 Public Portal Document

' F WTC Visual Survey Form Premise ddress: L Block: t_ `; Residential Commercial Name of Building: Lot: 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 ❑'/2 to 1" E1> 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" [2 >1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer [2 ½ to 1" [2 > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer [2 % to 1" [2 >1" Facade Description: .4i

Roof W st: Debris: ❑ No Visible /Fine tayer ❑ Y2 to 1" -1 = [2 >1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" [2 >1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" [1> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" [2 > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer [2 ½ to 1" [2 >1"

Comments L6 W N0 NCCu~ 3

Date: / cY /2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000094431