WTC debris inspection form, 87 Nassau Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form (00(21 1 Premise Address: ~~ c( j ?,,to ~-- [ 3 Block: Residential 0 Commer ial D Name ofBuilding: Lot: ► Mix Use ❑ Other fl # 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 Kesuits: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer D 1/tot" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" 0>1" East ❑ N/A ❑Yes ❑ No ❑ No Visible/Fine Layer ❑'/to1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" Facade Description:

Roof 4-

Debris: ❑ No Visible /Fine Layer ❑ Y2 to 1" 4 ° 0 0>1" / Description:

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

Date: T/ —/2002 Inspection Team: Name: > —_.. Agency: Name: Agency:

NYC-WTC 000099404