WTC survey form for 265 Water Street, 2002

NYC 9/11 Public Portal Document

WTC-V19val Survey Form P missAddress:

Block: bs Residential Commercia!2 Name of Building: Lot: Mix UseD Other S 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 9 Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inpected De ris North AMA es No o Visible/Fine Layer 'r4 to 1' > 1' South AMA J3Yes No No Visible/Fine Layer 36 to 1' > 1' East ❑ N/A Yes No No Visible/Fine Layer 34 to 1' > 1' West N/A Yes No No Visible/Fine Layer 34 to 1' H:0 1' Facade Description:

Roof

Debris: o Visible /Fine Layer .D 6 to 1' Description:

Setbacks WAD 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:____ No Visible/Fine Layer % to 1' > 1' Floor Debris: No Visible/Fine Layer % to 1' > 1'

Comments

Date: Inspection Team: Name:______ Agency. Name: ►~ Agency:

NYC-WTC 000109561