WTC inspection form, 269 Water Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Addee4 ? r

Block: { ResidentialD Commercial Name of Building: Lot: Mix UseD 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 Q No Exterior Survey Performed ❑ Yes No a

General Clean Up ❑ YesD No Locations: ACM Clean Up - ❑ Yes No Locations: Air Monitoring ❑ YesD No Locations: Copies of All Reports and Data Requested p Yes

Visual Inspection Results: Facade: Inspected Debris North N/A D YesD No ❑ No Visible/Fine Layer 9%t01' 9>1' South O N/A 9Yes9No ❑ No Visible/Fine Layer ❑ % to 1' 13>1' No Visible/Fine Layer D%to1' 0>1' East West ❑ N/A D N/A Facade Description: HYes0No D YesD No 0 (, E No Visible/Fine Layer D34to 1' 9>1'

Roof Debris: No Visible /Fine Layer D34to1' 9>1' Description:

Setbacks N/A Floor Debris:El No Visible/Fine Layer ❑ 3h to 1' 0>1' Floor Floor. Floor Debris:D No Visible/Fine Layer ❑ % to 1' Debris: 0 No Visible/Fine Layer Debris: No Visible/Fine Layer h to 1' 34 to V H9> ❑ > 1' > 1' 1' Floor.____ Debris: No Visible/Fine Layer 34 to 1' ❑ > 1'

Comments

Date: Inspection Team: Name: Agency: Name: Agency: ENTERED

NYC-WTC 000109567