WTC building exterior assessment form, April 2002

NYC 9/11 Public Portal Document

fP ~ ti Y WTC Visual Survey Form / Off" O 1 Premise Address:

Block: Lot: UL I

# of Stories: Residential Mix Use AKA's: Commercial p otherfl I Name of Building:

Building OwneIMan.gement Telephone Number. ( ) Name: o` 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 Q No Locations: ACM Clean Up ❑ Yes E] No Locations: Air Monitoring D Yes ❑ No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North D N/A JJ Yes 0 No 0 No Visible/Fine Layer % to V > 1' South Q N/A Q No o Visible/Fine Layer % to 1' > 1" East N/A Yes a No No Visible/Fine Layer H%tole >V West B N/A HYes0No No Visible/Fine Layer 4 to 1' > 1' Facade Description:

0 Roof

Debris: No Visible /Fine Layer .r] % to V D > 1' Description:

Setbacks N/A❑ Floor Debris: No Visible/Fine Layer % to 1' D > 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 34 to 1' > 1'

Comments

Date: Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000094452