WTC building inspection form, 14 Maiden Lane

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~, `~ a Block: Resident - Commercial 9 Name of Building: Lot: 3 Mix Use 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 Q No Exterior Survey Performed J Yes Q No General Clean Up ❑ Yes Q No Locations: ACM Clean Up ❑ Yes Q No Locations: Air Monitoring [] Yes Q No Locations: Copies of All Reports and Data RequestedEl Yes

Visual Inspection Results: Facade: Ins cted De ris North ❑ N/A No Visible/Fine Layer ❑ % to 1" 9> 1' South ❑ N/A ❑Yes ❑ No No Visible/Fine Layer JJ 14101. 9>1. East ❑ N/A ❑Yes No No Visible/Fine Layer % to 1' >1' West ❑ N/A ❑ Yes H No [] No Visible/Fine Layer h to 1" > 1" Facade Description: c* f, - Roof Debris: j10 Visible /Fine Layer .914101. Q > 1" Description:

Setbacks N/A ❑ Floor Debris: Q No Visible/Fine Layer ❑% to 1' Floor Debris: 0 No Visible/Fine Layer [] 4 to 1' Floor Debris: No Visible/Fine Layer % to 1' Floor Debris: No Visible/Fine Layer % to V Floor Debris: No Visible/Fine Layer 14 to 1" Comments

Date: i1 12002 Inspection Team: Name: ` '' " Agency: Name: Agency: rj TFRF

NYC-WTC 000101933