WTC Facade Inspection Form, 225 West Broadway

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential U Commercial p Name of Building: Lot Mix Use Other 0 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 Q No Exterior Survey Performed a Yes Q 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 JYesDNo No Visible/Fine Layer ❑ % to l' 0>1' South ❑ N/A JYesDNo No Visible/Fine Layer 74 to 1' 0>1' East N/A Yes ❑ No No Visible/Fine Layer ❑ ~Lto1' a>1'

West O N/A Yes ❑ No No Visible/Fine Layer tol' ❑>1' Facade Description: (\ _ _ -

Roof

Debris: No Visible /Fine Layer •[] 34 to 1' 9>1' Description:

Setbacks N/A Floor___ Debris: No Visible/Fine Layer % to 1' '1 . Floor Debris: No Visible/Fine Layer 74 to 1' >1' Floor____ Debris: No Visible/Fine Layer % to 1' > 1' Floor Debris: No Visible/Fine Layer 74 to 1' > 1' Floor Debris: No Visible/Fine Layer 74 to 1' '1' Comments I/

Date: / _12002 inspection Team: Name: Agency. Name: Agency:

s. •

NYC-WTC 000109716