WTC Facade Inspection Form, 141 West Broadway

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100/61 Premise Address:

Block: Residential 0 Commercial p Name of Building: Lot: Mix Use J Other # of Sto ies: 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 0 Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris North N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ va to 1" C]'? South ,] N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" [J'? East ®N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Ya to 1" 0>1" West ❑ N/A J 1Yes ❑ No No Visible ❑ Y to 1" ❑ > 1" Facade Description:

Roof

Debris: No Visible IE Jt r ❑Ytol" ❑>1" Description:

Setbacks N/A Debris: ❑ No Visible/Fine Layer 0 0>1" s

Floor. to 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to? ❑ > 1"

Comments

Date: 4/1/2002 inspection Team: Name: k/3117 I J)loEsu Agency: DES Name: Agency: ENTERED

NYC-WTC 000109670