WTC visual survey form, 4-6 White Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form /(Q 2I7% P emiie Address: _ WC Block: Residential CommercialD Name of Building: Lot / Mix UseD OtherlJ g of Stories: AKA's: Building Owner/Management Telephone Number ( ) Name: FAX: Address: On Site Contact: Name: ' ' .' . Telephone Number Building Owner Management Activities t. Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed O Yes ❑ No l General Clean Up ❑ Yes No Locations: ACM Clean Up ❑ Yes No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data RequestedD Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" ❑> 1" South ❑N/A ❑Yes❑No No Visible/Fine Layer ❑ % to 1" O'? East O N/A ❑ Yes O No No Visible/Fine Layer ❑%to 1" O)'1 West ❑N/A ❑Yes❑No O No Visible/Fine Layer ❑ % to 1" O)'l• Facade Description: n I.

V. Roof Debris: o Visible /Fine Layer .❑% to 1" ❑ > 1" Description:

Setbacks WA Floor___ Debris: O No Visible/Fine Layer ❑ i4 to 1" ❑> 1 0 Floor____ Debris: ❑ No Visible/Fine Layer ❑ % to 1" O>? Floor____ Debris: O No Visible/Fine Layer ❑ % to 1" ❑>1. Floor____ Debris: O No Visible/Fine Layer O % to 1" Floor____ Debris: O No Visible/Fine Layer O % to 1"

Comments

Date:./ 1R12002 Inspection Team: Name: Agency: Name: Agency: ENTERER'

NYC-WTC-000110093