WTC environmental inspection form, 87 West Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1/

Premise Address:

Block: 7sResidential 0 CommerciaI Name of Building: 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 fl Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes o ❑ No Visible/Fine Layer ❑Mato t" 0>1" South ❑ N/A ❑ Yes No ❑ No Visible/Fine Layer ❑Yato1" 0>1" East ❑ N/A ❑ Yes, o ❑ No Visible/Fine Layer ❑%%tot" 0>1" West ❑ N/A DYes1. No ❑ No Visible/Fine Layer ❑vato 1" 0>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer 0 % 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 ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Comments

Date: Inspection Team: Name: Agency: Name: Agency:

NYC-WTC-000110072