WTC building inspection form, 39 Worth Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form 10 0 i q 61 Premise Address:

Block: t74' Residential Commercial D I Name of Building: Lot: I Mix Use 0 Other 0 I C c. e-o.OA Q.e # of Stories: I AKA's: Building Owner/M na amen elephone Number. ( ) Name: FAX: Address: On Site Contact Name: u Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No U General Clean Up ❑ Yes 0 No Locations: ~~~0►~1 ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested D Yes

Visual Inspection Results: Facade: Inspected Debris North [Q'fI/A ❑Y s ❑ No Vsible/Fine Layer %tot ❑>1" South A ['Yes 0 No a Visible/Fine Layer % to t" 0>1k East A ❑ Yes 0 No ❑ No Visible/Fine Layer h to 1" 02-10 West Q~N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 034t01 D> 1 Facade Description:

Roof

Debris: to Visible /Fine ❑'It0I - t 9> 1- Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑'h to 10 0>1. Floor Debris: 0 No Visible/Fine Layer ❑ i4 to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0>1. Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1' Floor. Debris: 0 No Visible/Fine Layer ❑ i4 to 1" ❑ > 1" Comments

Date: `> / " /2002 Inspection Team: Name: Agency:0- Name: Agency: ENTERED

NYC-WTC- 000111010