WTC building inspection form, 10 Maiden Lane

NYC 9/11 Public Portal Document

WTC Visual Survey Form Biel* IOOIOQO Premise Address: 0 I Maiden kare. Block: Residential 0 Commercial J Name of Building: Lot: 21 Mix UseD Other # of Stories: AKA's: Building Owner/Management Telephone Number ( ) Name: 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 1 J Yes visual inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes 0 No ❑ No Visible/Fine Layer JJ '/ to 1" 0>1. South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer a to l" 0>T' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1" c~adg Description: W1r4 tQiZ& LM C1. 1~1tii11

Roof

Debris: ❑ No Visible /Fine Layer % to 1' 0>1" Description:

Setbacks N/A ❑ Floor Debris: [] No Visible/Fine Layer ❑ h to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ h to? 0>1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Floor Debris: 0 No Visible/Fine Layer ❑ % to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer 0V to 1" 9>1" Comments c or0 RD'S —"GL wo-0*w # tA G -

Date: ) / 090/2002 Inspection by: Name: P Agency: DEP Name: Agency: V,

NYC-WTC 000101929