WTC Facade Inspection Form, 137 West Broadway

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100((o( 3 Premise Address: /37 L-J. ;L Block: Residential 0 Comm rcialD Name of Building: Lot: Mix Use J OtherIJ # 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 ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris North N/A ❑ Yes ❑ No 0 No Visible/Fine Layer ❑ a to l" 0>1" South N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yatol" 0>1" East N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 4 to l" 0>1" West EN/A ® Yes ❑ No J0 No Visibl ❑%to 1" 0>1" Facade Description:

Roof

Debris: E[No Visible I1t1 Ya to? [] > 1" Description:

Setbacks N/A 2 Floor. Debris: ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 034101" ❑> V Floor. Debris:[] No Visible/Fine Layer ❑ 34 to V 0 > 1" Comments

Date: 'I I 12002 Inspection Team: Name: F<A7v1 W Ghi Agency: _ Qg,O, Name: Agency: ENT ERED NYC-WTC 000109662