WTC debris inspection form, 15 Maiden Lane

NYC 9/11 Public Portal Document

WTC Visual Survey Form :BN-* 1001097 Premise Address: S. 1 ,v O4 . f iP••

Block: (aS Residential 0 Commercial Name of Building: Lot: I Mix UseD Other # of Stories: AKA's: Building Own /Management: Telephone Number: ( ) Name: -Q.U1Qç 7y j ç hi FAX: Address: i On Site Contact: Name: - s o 7 o Telephone Number: Building Owner Management Activities Interior Survey Performed es ❑ No Exterior Survey Performed qK.Wj 111es F1No General Clean Up El Yes ❑ No Locations: ACM Clean Up 0 -Yes ❑ No Locations: Air Monitoring ® Yes ❑ No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑%tol" 0>1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑%to 1" 0>1" East ❑ NIA ❑ Yes ❑ No No Visible/Fine Layer ❑%tol" ❑>1" West ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑%to1" 0>1" Facade Description: _

Roof " Debris: No Visible /Fine ayer ❑ % to 1" •? = ❑ > 1" •~'"'~ Description:

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

Date: x/1/2002 Inspection Team: Name: A- %"--7 Agency: HC Name: V Agency:

NYC-WTC 000102068