WTC building inspection form, 112 Liberty Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form P~o~2 Premise Address: 3 C C

Block: 5 Residential EJ Commercial J Name of Building: Lot: SO I Mix Use LI Oth r # of Stories: AKA's: Building Owner/Managemen : 7J (e- Telephone Nu ber: ( ) tj 0 FAX: ( Name: ) 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 EN/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2to 1" E>1" South _ ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to l" [` .1" EN/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/ 2 tol" n>1" East West ,®ZI/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ '/2 to l" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer -to 1" ❑ > 1" Description: n

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

Comments

Date: /2002 Inspection Team: Name: L. L ice" Agency: ix-r f Agency: Name:

NYC-WTC 000100567