WTC Site Document, 90-92 West Broadway

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential Commercia Nam of Building: Lot: Mix Use Other f J # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: \ w e-w- — 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 Yes

Visual Inspection Results: Facade: Inspected Debris North ❑N/A 's❑No

_ .No Visible/Fine Layer ❑%to l" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" East ❑ N/A ifes ❑ No to Visible/Fine Layer ❑Y2 to l" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yato1" 0>1" Facade Description:

Roof

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

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" [1> 1" 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 ❑ Y to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1"

Comments

Date: ) / v /2002 Inspection Team: Name: C// "1 Agency: Name: Agency: V

NYC-WTC-000109612