WTC building inspection form, 41 Worth Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form I r) r)( ñ Premise Address: it ( Block: 11Co Residential , CommercialD Name of Building: Lot: l0 Mix Use Other #of Stories: AKA's: Building Owner/Manage ent: Telephone Number ( ) Name: FAX: Address: Io ôotZ—Z3 On Site Contact Name: ' ' .. . • Telephone Number. Building Owner Management Activities Interior Survey Performed 0 Yes 0 No Exterior Survey Performed 0 Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: UK ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring 0 Yes ❑ No Locations: Copies of All Reports and Data RequestedD Yes

Visual Inspection Results: Facade: Inspected Debris North [f N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 14to1" 0>1" South ❑ N/A Q4es ❑ No [-No Visible/Fine Layer ❑ 14 to 1" 0>1" East 0 N/A Q'S'es ❑ No D-No Visible/Fine Layer ❑ f to 1" 0>1" West ON/A ❑Yes❑No ❑ No Visible/Fine Layer ❑%to l" 0>1" Facade Description:

Roof Debris: [ to Visible /Fine Layer ■

Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer []34 to 1" > 1" Floor Debris: ❑ No Visible/Fine Layer a

34 to V 0>1' Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" 0>1' Floor Debris: 0 No Visible/Fine Layer ❑ % to V 0>1. Floor. Debris: ❑ No Visible/Fine Layer ❑ 4 to 1" 0>1' Comments

Date: A /1 12002 Inspection Team: Name: Agency: Name: Agency: £N TERE

NYC-WTC 000111019