WTC building inspection form, 112 Liberty Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form N~on ' 1 1 ' ' 2-J Ce Pr~mi a Address: Cs '-4 Block: ResidentialD CommercialD Name of Building: Lot: -5O I Mix UseD Oth # of Stories: AKA's: — / Building Owner/Managemen : (~ Telephone Nu ber: ( ) O 1J 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 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1'" South _ ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/% to 1" East . ff N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0> 1" West 53 ZI/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description: v G~

Roof ❑ > 1" Debris: Description: ❑ No Visible /Fine Layer 0"o 1" f2_ J A Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 0V 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 ❑ % to 1" ❑ > 1"

Comments

Date: 1 Z T 12002 Inspection Team: Name: Lam' Agency: ix —r ( Agency: Name: Si NYC-WTC 000100622