WTC facade inspection form, 95 Wall Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form PrF 3 Address:

Block: I ResidentialD Commerciat Name of Building: Lot I Mix UseD Other # of Stories: AKA's: — — Buiidin Owner/Manage nt Name: Address: .Qti A Telephone Number. ( FAX: ( Q )

On Site Contact Name: ' ' ele hone Number. Building Owner Management Activities Interior Survey Performed ❑Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: 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 ❑ No Visible/Fine Layer ❑%to 1' 0>1' South ❑N/A ❑Yes❑No No Visible/Fine Layer ❑%tol' 0>1' East ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ % to 1' ❑ > 1' West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 034to1' 0>1' Facade Description: i ~ A

Roof Debris: I to Visible /Fine Layer •0 4 to 1' ❑ > 1' Description:

Setbacks N/A'' Floor: Debris: ❑ No Visble/Fine Layer ❑ S4 to 1' 0>1. Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ A to 1' ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ % to V 0> 1' Floor ~ Debris: ❑ No Visible/Fine Layer ❑ 4 to 1' ❑ > 1' Comments F %

4 Date: ,)/(_2002 Inspection Team: Name: 9 L Agency: Name: ______________________Agency:

NYC-WTC-000112634