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WTC inspection form for facade and setback assessment

Machine-extracted title · confidence 85%

Inspection checklist recording visual results for building facades and setbacks at a specified location.

NYC-WTC_000100517–000100518

Folder label: “69 MURRAY ST 1001420, 132/2”

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NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential Commercial D Name of Building: Lot: Mix Use ❑ Other # of Stories: Cf AKA's: Building Own /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 j 1 Yes

visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" South ❑ N/A j3Yes ❑ No No Visible/Fine Layer ❑%to 1" 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" Facada Descnpt•ion.

Roof

Debris: ❑ No Visible /Fine Layer ❑ Y2 to 1" ❑ > 1" Description: PC- k'-o

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 ❑ Y to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments No &

> ')I MAAo) ~ In~nnnlinn Team• Mme• Annnr w Name: ~~i ~Y ! -1 y Agency: ABU 7 NYC-WTC 000100517

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NYC-WTC_000100517Source: NYC Law Department, mirrored locally

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