WTC building inspection form, 14 Maiden Lane

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 4. Block: Resident — Commercial 9 Name of Building: Lot Mix Use 9 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 0 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: Inpecthd De ris North ❑ N/A Fes ❑ No No Visible/Fine Layer E] % to 1 0>1* South ❑ N/A ❑ Yes 0 No ❑ No Visible/Fine Layer ❑% to 1' 0>1* East ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer E] % to 1' 0>1* West E] N/A E] Yes ❑ No E] No Visible/Fine Layer 034t01* ❑ > 1" Facade Description: (1 LS.t

Roof

Debris: o Visible /Fine Layer .❑

% to 1" 9> 1' Description:

Setbacks N/A 0 Floor Debris:E] No Visible/Fine Layer ❑'4 to 1' 9>1 Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' 0>1' Floor. Debris: ❑ No Visible/Fine Layer 9'r4 to 1' 0>1' Floor. Debris: j] No Visible/Fine Layer 0 % to 1" L]>1' Floor. Debris: 0 No Visible/Fine Layer ❑ '4 to 1" L] > 1' Comments

Date: i1 12002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000101932