WTC building inspection form, 33 Worth Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form to tQ 62 Premise Address:

Block: i—i Residential Comma i I N e o B Iding: Lot: I a1 Mix Use Other ZcC ij. # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: 5 3 -- r e FAX: Address: 3'5 0oa- N. . 1J. _ too k3-a43S, On Site Contact:, Name: ' Telephone Number Building Owner Manag ment Activities Interior Survey Performed ❑ Yes 0 No Exterior Survey Performed 0 Yes 0 No General Clean Up 0 Yes 0 No Locations: ACM Clean Up 0 Yes 0 No Locations: Air Monitoring 0 Yes 0 No Locations: Copies of All Reports and Data RequestedD Yes

Visual Inspection Results: Facade: Inspected Debris North Q1i/A ❑YesONo ❑ IJo Visible/Fine Layer ❑%to1" 0>1" South 0 N/A [-des 0 No o Visible/Fine Layer ❑Mato 1" 0>1' East 9' /A ❑ Yes Q No ❑ No Visible/Fine Layer 04to1" 0>1" West N/A DYesDNo ❑ No Visible/Fine Layer 0hto1" 0>1" Facade Description:

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

Setbacks N/A[" Floor. Debris: 0 No Visible/Fine Layer ❑ 34 to 1" 0>1' Floor. Debris: No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: [D No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor Debris: 0 No Visible/Fine Layer 0 % to 1" ❑ > 1" Comments

Date: 4/ =1 /2002 Inspection Team: Name: Name: [0, Agency: Agency: F0

NTERE

NYC-WTC-000111003