WTC Building Inspection Form, 112 Liberty Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Residential - L Commercial L Name of Building: Block: Lot: Mix Use ❑ Other # of Stories: . KA's: Building Owner/Management: Telephone Number: ( ) Name: r } ( 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 j J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A des ❑ No ❑ No Visible/Fine Layer ❑'/to1" 1" South ❑ N/A t Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0> 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2to1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer E]'/z to 1" 0>1" Facade Description:

Roof

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

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

Comments

c~ Agency: ~~ Date: I / 26 /2002 Inspection Team: Name: L Lij f C l Name: Agency:

NYC-WTC 000100627