WTC building inspection form, 1 Worth Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: / Lot: , / Residential `f Mix UseD Other Com rci I oS Name of Building: '3J J.jf # of Stories: f AKA's: Building Owner a ageme : Telephone Number. ( ) Name: Mt FAX Address: O On Site Contact: Name: 0 &C2LQt Telephone Number. Building Owner Management Activities Interior Survey Performed 0 Yes ❑ No Exterior Survey Performed 0 Yes ❑ No General Clean Up 0 Yes ❑ No Locations: 1 (iii t 'knv ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring 0 Yes ❑ No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North [ /A H[:] Yçs ❑ No ❑ No Visible/Fine Layer ❑ 34 to 1" 0> 1' South ❑ N/A Q.Yès ❑ No 014° Visible/Fine Layer ❑ % to 1" ❑ > 1" East ( N/A ❑ Yes 0 No ❑ No Visible/Fine Layer ❑ % to 1" 0)1" West EN/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 34 to 1" .0> 1" Facade Description:

Roof Debris: D1'o Visible /Fine Layer 0 Va to 1" ❑> 1 " Description: aa

Setbacks N/A L3' Floor Debris: 0 No Visible/Fine Layer ❑ y4 to? 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0>? Floor: Debris: 0 No Visible/Fine Layer 0 V: to? ❑ > 1" Floor Debris: 0 No Visible/Fine Layer ❑ % to 1' 0>1. Floor Debris: ❑ No Visible/Fine Layer ❑ % to? 0>1" Comments

Date: 11002 Inspection Team: Name: Agency: / NTE RE Name: Agency:

NYC-WTC 000110991