Building operation permit, Manhattan, July 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~ V ~1 Block: Residential 0 Commercia . Name of Building: Lot: Mix Use 0 Other fl # 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 % to 1" ❑ > 1" South ❑ N/A /❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y to 1" 0>1" West 0 N/A [ es ❑ No ❑ No Visible/Fine Layer , to 1" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer 0 % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: 0 No Visible/Fine Layer ❑ %2 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 ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"

Comments

Date: // ' /2002 Inspection Team: Name: `' V Agency: ._ NTEREO Name: Agency:

NYC-WTC-000110615