WTC visual inspection form for commercial building, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100 P ise Address: ,~ t cc jf ~'Gt-4c~...—1 Bloc .: Residential 0 Commercial L Name of Building: Lot: . Mix Use D Other El # 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 0 Yes

visual inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ to 1" Y2 ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ %2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer El ½ to 1" ❑ > 1" Facade Description: Q `` 4'yT E. c Q

Roof ? Js.t; Debris: ❑ No Visible /Fine tayer ❑ /2 to 1" -1 - 0>1" .1 Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ h/ 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"

Comments

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

NYC-WTC 000099918