WTC building inspection form, 22 Maiden Lane, undated

NYC 9/11 Public Portal Document . Prerrlee • WTC 1nsua suree Form ` .100 1p F `~~, AddressM . Block: ResidentIaJ Commercial 0 I Name of Building: Lot 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 p Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer tJ 34 to 1" 0>1' South ❑ NIA ❑ Yes ❑•No ❑ No Visible/Fine Layer '/ to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1" West ❑ N/A ❑ Yes 0 No ❑ No Visible/Fine Layer J to 1" 0>1" Facade Description:

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 ❑ % to 1" ❑>1" Floor Floor Debris: 0 No Visible/Fine Layer ❑ Y to 1" Debris: ❑ No Visible/Fine Layer ❑ Yz to 1" a>1" ❑>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Comments

Date: Inspection by: Name: Al. - Agency: Name: Agency:

-7

NYC-WTC 000102162