WTC building inspection form for 75 Maiden Lane

NYC 9/11 Public Portal Document

WTC Visual Survey Form R N * 1 C0 11) Z Premise Address: !15 M a i ~d e- Y-) Block: Residential 0 Commercial f Name of Building: Lot: Ii Mix Use 0 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 J Yes Visual Inspection Results: Facade: Inspected Debris North ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer '/to1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer '/to1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer flfl4 tol" ❑>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer %tot" []:..I* Facade Description: A • .

Roof

Debris: o Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" 0>1" Floor. Debris: 0 No Visible/Fine Layer ❑'/2 to 1" 0>1" Floor. Debris: 0 No Visible/Fine Layer ❑ 1 to 1" ❑ > 1"

Comments

Date: o? /v2t)/2002 Inspection by: Name: AR Agency: EP Name: Agency:

NYC-WTC 000102321