WTC building exterior assessment form, April 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: Block: j I Residential 0 mmercial J Name of ii i Lot: Mix Use J OtherD RL # of Stories: AKA's: Building Qwn r a Bement Telephone Number. Name: kiii nrT FAX Address: C ti On Site Contact Name: " ' Telephone Number Building Owner Management Activities Interior Survey Performed 8Yes8No Exterior Survey Performed Yes No General Clean Up Yes No Locations: ACM Clean Up g Yes No Locations: Air Monitoring 0 Yes ❑ No Locations: Copies of All Reports and Data Requested DYes

Visual Inspection Results: Facade: Inspected . Debris North N/A DYes No O No Visible/Fine 14 to 1' > 1' South N/A g No No Visible/Fine Layer 14 to 1' > 1' East fl N/A Yes 0 No No Visible/Fine Layer 14 to 1' > 1' West N/A DYesDNo No Visible/Fine Layer LayerHyStole > 1' Facade Description:

Roof Debris: Visible /Fine Layer .L] % to 1 El > V Description:

Setbacks N/A0 Floor___ . Debris: No Visible/Fine Layer 14 to V D >V Floor____ Debris: No Visible/Fine Layer 14 to 1' > 1' Floor.___ Debris: No Visible/Fine Layer % to 1' > 1' Floor Debris: No Visible/Fine Layer 14 to 1' > 1' Floor.___ Debris: No Visible/Fine Layer 14 to 1' > 1'

Date: Inspection Team: Name: _(t Agency. /- Name: Agency:

NYC-WTC 000094455