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← Document results/DEP Box 39/177 WEST BROADWAY; Block: 176, Lot: 16, BIN: 1001965
Document / 4 pages

WTC Facade Inspection Form, 177 West Broadway

Machine-extracted title · confidence 95%

Form recording facade inspection results for the building at 177 West Broadway.

NYC-WTC_000109689–000109692

Folder label: “177 WEST BROADWAY; Block: 176, Lot: 16, BIN: 1001965”

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Scanned page image, NYC-WTC_000109689
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NYC 9/11 Public Portal Document

WTC Visual Survey Form / ,,A %( PzemiseAddress:

Block: Residential Commerci Name of Bull ng: Lot: Mix Use 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 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 j Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A fl YesDNo No Visible/Fine Layer ❑i4to1' 0>1' South ❑ N/A Yes No No Visible/Fine Layer East ❑ N/A Yes No No Visible/Fine Layer i4 to 1' H:10 1' West N/A a Yes ❑ No n No Visible/Fine Layer ❑%to1- ❑>1' Facade Description: t,

Roof Debris: No Visible /Fine Layer .❑ %e to? 0>1' Description:

Setbacks WA Floor Debns. ❑ No Visible/Fine layer 3'4 to 1 >1 Floor Debris: No Visible/Fine Layer a

% to 1' >1 Floor Debris: ❑ No Visible/Fine Layer y4 to 1' > 1' Floor. Debris: 9 No Visible/Fine Layer %s to 1' > 1' Floor Debris: No Visible/Fine Layer ❑ % to 1' 0>1. Comments

Date: J / 12002 Inspection Team: Name: Agency. Name: Agency:

NYC-WTC 000109689

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NYC-WTC_000109689Source: NYC Law Department, mirrored locally

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