WTC building inspection form, lead and facade assessment

NYC 9/11 Public Portal Document

WTC Visual Survey Form Pre,nise Address: ~f LEAo'~ Bloc I I Residential 0 Commercial Name of Building: Lot: Mix UseD Other # of tones: i AKA's: Building Owner/Management: £3i 7S RE/•Ty Telephone Number: (21Z) 9-v'/-2 37 / Name: /)2(Y -;ç Fr~r u h FAX: Address: C . v, /L st ^(i' On Site Contact: Name: ' r( rl - Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ® Yes ❑ No Locations: 16t J r &.~--J-5' c %-'-•-- ACM Clean Up ❑Yes E No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

visual inspection Kesults: Facade: Inspected Debris North ❑ N/A ® Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" 0>1" South N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" 0>1" East RN/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to in 0>1" West ❑ N/A ®'Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ® % to 1" ❑ > 1" Description: Pe- J—' rail'_ ' t P7. -S ,t'e r f i c2 t-- .

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 ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: 2— /x/2002 Inspection Team: Name: ( 'w.- Agency: o(' Name: Agency:

NYC-WTC-000110283