WTC building inspection form, 14 Maiden Lane

NYC 9/11 Public Portal Document

F] WTC Visual Survey Form ó I 'Pre se Address:

Block: Residential 0 Commercial E 1 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 ❑ 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 Kesults: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > I" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ / to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Facade Description:

Roof 1., ❑ Y2 to 1" .1 ; 'I Debris: ❑ No Visible /Fine Layer 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > I" Floor: Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" ❑ > I" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No VSible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1"

Date: 3 /x/2002 Inspection Team: Name: '~-- Agency: Name: Agency:

NYC-WTC 000101934