WTC building inspection form, 112 Liberty Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: \ Lu. i-.. C f ---'1 Block: Residential El Commercial r:7 Name of Building: Lot: Mix Use ❑ Other ❑ # of Stories: KA's: Building Owner/Management: Telephone Number: ( ) o 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

vlsuai inspection r~Cauiw. Facade: Inspected Debris North ❑ N/A s ❑ No ❑ No Visible/Fine Layer ❑'/z to 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 ❑'/z to 1" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ❑ % to 1" Description:

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

I Comments

1 t4Ac n..a.,. I Z inn' Incncr:tinn Team• Name` L L ~'` Agency: Name: Agency:

NYC-WTC 000100572