WTC inspection form for 79 Warren Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: C a e 4 '-1 Block: Residential D Commercial 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 Visible/Fine Layer ❑% to 1" ❑ > 1" South 2/ A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" East N ❑ Yes ❑ No ❑ No Visible/Fine Layer to 1" ❑'/% ❑ > 1" •West /A ❑Yes❑No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Facade Description: _ 11 /eiO4 i i r( iXz Roof

Debris: ❑ No Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer L1% to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer []% to 1" [1> 1" Comments

Date: IL-c /2002 Inspection Team: NamePJ-Y't1 Name: 1 LL Agency; Agency:

NYC-WTC-000112838