WTC environmental inspection form, 159 Maiden Lane, 2002

NYC 9/11 Public Portal Document

.. WTC Visual Survey Form Premise Address: S Mkbf L, JS Block: Residential Commercial D Name of Building: Lot: Mix Use Other # 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 Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 7Y2 to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>I - East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer [:]Y2 to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to 1" ❑> 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine 1..ayer ❑ Y2 to 1" 1 ~''' ❑ > 1" 1 Description:

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

Comments MOdE

Date: _'/_/2002 Inspection Team: Name: _&1 ( 4 Agency: ENTERED Name: DO Z Lit) Agency: _QL__

NYC-WTC 000100064