WTC debris inspection form for residential building, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 37 \Jci T? -ET Block: Residential U Commercial U Name of Building: Lot: Mix Use ❑ Other # of Storie AKA's: Building Owner/Management: Telephone Nu er: (~ 2 ) Z 6 j Name: q FAX: ) Address: On Site Contact: Name: o- '&irj jeIephone Number: (2r ) z s - [ 6 Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations:_ 1/l.Q a-4J a( Q . ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No SNo Visible/Fine Layer /4 to 1" ❑ > 1" South ❑ N/A Yes El No El No Visible/Fine Layer ;F/ to 1" ❑ > 1" East ❑ N/A RYesE] No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description: FQ O 2NA-r~C - GN (2 ) 07HER A2v ta C l p A*1 ON 1'~0 . SC~t1TN \S LS S e (2AJ Air Au T Lc 1 P. RAS A-r O PS off' - -r f-S AT LESS . P" dV-wA`I N\P,V,16 WT,I.L s-r2Ee-r eKC-RAt&6 € Roof

Debris: ❑ No Visible /Fine Layer '[4' z o 1" ❑ > 1" De ripti n: — ri —1'c

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑'/Z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: / (L /2002) Inspection by: Name: Agency: 1'M Name: _Agency:

NYC-WTC-000112034