WTC Building Inspection Form, 112 Liberty Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: r ~o

Block: 5' Residential El Commercial 0(~ ( I Name of Building: Lot: 50 Mix Use Other ❑ # of Stories: AKA's: — Building Owner/Management: Te ph ne Number: ( ) Name: IJ C/ FAX: Address: On Site Contact: Name: * Telephone Number: ( ) Building Owner Management Activities n 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 El Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" J > 1" South ., N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" East ER N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑v to 1" 0>1" West RN/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Facade Descrip ion:

Roof

Debris: ❑ No Visible /Fine Layer ❑%2to1" >1" Description: ►v >ne ,Q V

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1"

Comments

Date: ~/ v) /2002 Inspection Team: Name: '.. 11 Agency: W '-'r Name: Agency:

NYC-WTC 000100626