WTC facade inspection form, 90 Maiden Lane, Oct 2001

NYC 9/11 Public Portal Document

WIC Visual Survey Form 100101 P Yse Address: 7O i L Block: Residential D Commercial Name of Building: Lot: Mix Use D Other # of tories: 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 BYes ❑ No Locations: ACM Clean Up D Yes ❑ No Locations: Air Monitoring JYes ❑ No Locations: Copies of All Reports and Data Requested Yes

visual inspection tcesuits: Facade: Inspected Debris North ❑ N/A E YesDNo No Visible/Fine Layer ❑Y2to l" 0>1" South N/A Yes ❑ No ff No Visible/Fine Layer 0%to1" 0>1" East J N/A D Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" West N/A ❑ Yes ❑ No ❑ No ViSible/Fine Layer ❑%to1" 0>1" Facade Description:

Roof

Debris: ❑ % to 1" 0>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 ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No ViSible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: 2---f4 OO2 Inspection Team: Name: Judo k Agency: PCI' Name: Agency: a It9 f a_a~2

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