WTC building inspection form, 9 Worth Street

NYC 9/11 Public Portal Document

/ WTC Visual Survey Form tO D / W Premise Address: Block: Residential Commercial D Name of Building: Lot: Mix Use Other # of Stories: 4 AKA's: )p r - / 7 3 (i) ' 2) (T),14 9D'( Building Owner/Management Telephone Number. ( ) Name: 71 V e.r I✓ u i l e a FAX: Address: bn4 -70 i On Site Contact: Name: * ' ." Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed 0 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 es

Visual Inspection Results: Facade: Inspected Debris North Q4I/A ❑ es ❑ No ❑ No Visible/Fine Layer ❑ 34 to? 0>1' South ❑ A QYes ❑ No Olcio Visible/Fine Layer ❑ ~4 to? 0>1' East VA ❑Yes ❑ No Visible/Fine Layer D to 1" 3 ❑ > 1" West ❑ N/A [3es ❑ No Hro Visible/Fine Layer ❑ 34 to 1" 0>1' Facade Description:

Roof Debris: Q'No Visible /Fine Layer ❑ h to 1" ❑ > 1" Description:

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' 0>10 Floor. Debris: ❑ No Vsible/Fine Layer 034t01' 0>10 Floor. Debris: ❑ No Visible/Fine Layer ❑'h to? ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ i4 to 1 ❑ > 1' Comments

Date: 5/ ~' 12002 Inspection Team: Name: C Agency: Ate° Name: C Agency: E NTERED

NYC-WTC-000111000