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← Document results/DEP Box 39/175 WEST BROADWAY; Block: 176, Lot: 14, BIN: 1001964 AKA:
Document / 5 pages

WTC Facade Inspection Form, 175 West Broadway

Machine-extracted title · confidence 95%

Form recording facade inspection results for the building at 175 West Broadway.

NYC-WTC_000109683–000109687

Folder label: “175 WEST BROADWAY; Block: 176, Lot: 14, BIN: 1001964 AKA:”

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Scanned page image, NYC-WTC_000109684
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NYC 9/11 Public Portal Document

WTC Visual Survey Form ICoj 9~ Frerhise Address: f ,~ w 3 I I dock: Residential Commercial Name o uiiding: Lot: Mix Use Offer # oY Stories: AKA's: Building Owner/Management Telephone Number ( ) Name: FAX:( Address: On Site Contact: Name: ' ' .. . Telephone Number. Building Owner Management Activities Interior Survey Performed HYesHNo Exterior Survey Performed Yes No General Clean Up DYes No Locations: ACM Clean Up 0 Yes No Locations: Air Monitoring O Yes O No Locations: Copies of All Reports and Data Requested D Yes

Visual Inscection Results:

Inspected Debris North ❑ N/A ❑ Yes D No' No Visible/Fine Layer 14 to 1' 1-131-10 South ❑ N/A Yes[] No No Visible/Fine Layer %to 1' 0>? East N/A Yes O No No Visible/Fine Layer %to 1' ❑> 1' West ON/A YesONo No Visible/Fine Layer %to 1' 0>? Facade Description _

Roof

Debris: No Visible /Fine Layer .0 % to 1' 0> 1' Description:

Setbacks N/AI, Floor Debris: 0 No Visible/Fine Layer % to 1' > 1' Floor Debris: No Visible/Fine Layer % to 1' > 1' Floor Debris: [I No Visible/Fine Layer % to 1' > 1' Floor Debris: No Visible/Fine Layer 34 to 1' > 1' Floor____ Debris: No Visible/Fine Layer 03610? > 1'

Comments 'L

Date: !72002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000109684

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NYC-WTC_000109684Source: NYC Law Department, mirrored locally

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