47 West Street Form Record, DEP Box 39

NYC 9/11 Public Portal Document

WTC Visual Survev Form Premise Address:

Block: Residential Commercial p Name of Building: Lot: MixUseD 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 Yes visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/to1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2tol" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>10 West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yto1" 0>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ❑ Y to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑'% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer 0 % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 14 to 1" ❑ > 1"

Date: c /,,_/2002 Inspection by: Name: C.,L_ Agency: Name: Agency:

NYC-WTC 000110008