WTC building inspection form, facade damage documentation

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1O010I2. Premise Address: 1 W /L --IM $7 Block: Residential Commercial Name of Building: Lot: Mix Use Other D ur t4 iF Vi ^ 1 c ' c 1-~. # of tortes: tt YN AKA's: Building Owner/Management: av r 1 ('1 £ Telephone Number: (2 iz_.) 4-2 z S 3 S— Name: E c /rs r /n ; FAX: Address: On Site Contact: - Name: /1'r. Z% Telephone Number: ( Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up 7 Yes ❑ No Locations: ACM Clean Up ❑ Yes gNo Locations: Air Monitoring ❑ Yes, No Locations: Copies of All Reports and Data Requested Yes

♦I~Jual III,EJC oL V11 RC0U La.

Facade: Inspected Debris North Q N/A BYes ❑ No JE Ne-Visible/Fine Layer [J to 1" 1/2 ❑ > 1" South ❑ N/A Yes ❑ No ® Ne-Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A ,Q Yes ❑ No , Nn- Bible/Fine Layer ❑'/2 to 1" ❑ > 1" West ❑ N/A ® Yes ❑ No No—Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Facade Description:

Roof

Debris: EaNeiJi,ible4Fine Layer '/2 to 1" ❑ > 1" Description: I]

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" Floor: Debris: ❑ No ViSible/Fine Layer ❑'/2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'h to 1" Floor: Debris: Q No Visible/Fine Layer ❑ %2 to 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1"

Comments

Date: _2 / i ` 12002 Inspection Team: Name: Agency: ,P Name: Agency:

NYC-WTC 000110289