WTC debris inspection form for residential building, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form r %F+3119 2 Premise Address: 31 trUc\1 Block: I Residential U Commercial D Name of Building: Lot: Mix Use ❑ Oth r of Stone AKA's: Building Owner/Management Telephone Name: FAX: ) Address: On Site Contact: Name: c~ r — LA jJelephone Number. ('LrZ z t- t Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: 4W OW 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 ❑'h to? ❑ > I" South ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer j/2 to 1" ❑ > 1" East ❑ N/A DYesDNo ❑ No Visible/Fine Layer ❑ % to 1" O>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to I" ❑ > 1" Facade Description: ~ tI R-1 O t -rrc - CK E" 0, S £ O7KER CR2y \t~' S GLEAM 014 NORTH . 5(7Trf-I c c J I -r RUT r-c uc t F_ RAS kr io PS off' C-PP-r S t A-r Pc ba %( tAK rJ W%" w, 12E,cr Ex c i-t p.&6- - Roof

Debris: ❑ No V sible /Fine Layer 'f ' 21 to 1" ❑ > 1" De riptipPn~• k r (G er c \L . r- — X11Q\ 0 .,nD rn Ir C`C' %l r S fli P

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" O>? Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ V2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" O>?

Comments Li

Date: -I (L /2002 / v Inspection by: Name: wM ~ ~ Agency: Name: Agency:

NYC-WTC-000112043