WTC building inspection form, 112 Liberty Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: `3 Ce &c Block: Residential 0 Commercial p I Name of Building: Lot: Mix Use ❑ Other 0_- # of Stories: AKA's: / : Building Owner/Management: R 1o Cl Te ep on um er: ( ) Name: r` 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 Kesults: Facade: Inspected Debris North N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/i to 1" ❑ > 1" South _ ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" [ 1" East .'N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Facade Description: v G~

Roof

Debris: ❑ No Visible /Fine Layer jEl-to 1" ❑ > 1" Description: i , ,. v 11P a n.r' — /1,.> a r bJ ✓i- -

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

I Comments

n..a,.. l , r3nn,5 Inenoetinn Tpnm• Name, (_/ L AQencv: Name: Agency:

NYC-WTC 000100601