Building inspection form for World Trade Center site, facade and

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: T5 t i AsSAJ SV EE'V Block: T9 Residential 0 Commercial 0 Name of Building: Lot: 6 Mix Use Other # of Stories: 6 AKA's: 79 w~ss,-u s,-ee-T a► N AS MJ S - r 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: QOnF a,Jo 11cADts ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Q Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A E) Yes ❑ No ® No Visible/Fine Layer ❑Y2to1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%2to1" ❑>1" East ❑ N/A ED Yes ❑ No No Visible/Fine Layer ❑Y2to1" 0>1" West ❑ N/A D Yes ❑ No ❑ No Visible/Fine Layer 0%to1" 0>1" Facade Description:

Roof

Debris: to No Visible /Fine Layer 0114t01" 0>1" Description:

Setbacks N/A R Floor: Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer 0'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

Date: o8 / 28 /2002 inspection Team: Name: -DA /A020 Agency: 'D P Name: Agency: E NTEREL 4 NYC-WTC 000099944