WTC exterior inspection form, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Prem ei lA eT iW 1~1 Block: Residential Commercial Name Bu ding: Lot» Mix Use . Other- M -~ # of Stories: AKA's: Building Owner/Management Telephone Number ( ) Name: FAX: Address: On Site Contact: Name: Telephone Number f 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 0 No Locations: Copies of All Reports and Data Requested DYes Visual Inspection Results: Facade: Inspected rls North ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer 0 1/2 to 1" 0>10 South ❑ N/A ❑ Yes ❑'No o Visible/Fine Layer ❑ %2 to 1* 0>10 East ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ 34 to 1" 0>10 West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑'/2 to 1" 0>1 0

Facade Description:

Roof Debris: sible /Fine Layer ❑'/2 to 1* ❑ > 1" Description:

Setbacks N!k4/) Floor Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" 0> 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ %2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1* Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1* ❑ > 1" Comments

Date: Inspection by: Name: Agency: Name: Agency:

NYC-WTC 000110902