WTC inspection form, 83 Maiden Lane, 2002

NYC 9/11 Public Portal Document

a •- 9 WTC Visual Survey Form &s 10011t 1 Premise Address: Q rn O3 a f ~ en I,~a Y~~ Block: b$ Residential 0 Commercial Name of Building: Lot: Mix Use J Other # of S ties: 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 InsDection Results: Facade: Inspected Debris North ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer %tot" ❑>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer '/to1" 0>1" East Q N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer %to1" ❑>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer LOYatol" 0>1" Facade Description:

Roof

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

Setbacks N/A ❑ 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 ❑ Va to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer 0 Va to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer [] % to 1" ❑ > 1" Comments

Date: I 12002 Inspection by: Name: Pi P Agency: EP Name: Agency:

NYC-WTC 000102458