WTC inspection form for 76 Warren Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential' j Commercial D Name of Building: Lot: Mix Use ❑ Other ❑ # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: ( ) Address: On Site Contact: Name: Telephone 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 i i le/Fine Layer ❑'/z to 1" ❑ > 1" South ❑ N/A )r'es ❑ No E -No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" West ❑N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer D'/z to 1" ❑> 1" Description:

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

Comments

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Date: '1 / ~-~ /2002 Inspection Team: Name: ''~~C\ Ck• Agency:V~ I C Name: r4 c ,i i Agency L ~

NYC-WTC-000112825