Facade measurement form, WTC cleanup, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: i 6s

Block: I` , Residential p Commercial p tt4me of Building: Lot: I Mix Use 0 Other # of Stories: j 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 fl Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑Yes ❑ No ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" South ❑ N/A 1 Yes 0 No ❑ No Visible/Fine Layer 3'/2 to 1" ❑ > 1" East ❑ N/A ❑Yes ❑ No ❑ No Visible/Fine Layer Q , to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description: D i t

Roof Est Debris: ❑ No Visible /Fine yer [3'/ to 1" ? =i'" jJ > 1" 1 Description: f nr ~,1'ci'"t",~ 3"' 1v

Setbacks N/As Floor. Debris: Q No Visible/Fine Layer 0 a to 1" [J> 1" Floor. Debris: Q No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑'/:to 1" 0> 1" Floor: Debris: 0 No Visible/Fine Layer ❑ Va to 1" 0> 1" Floor____ Debris: 0 No Visible/Fine Layer 0 Va to 1" 0> 1" Comments ('1A A 442- t 1 c';

Date: 0 t 1 2 _/2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000099609