WTC debris inspection form, New York Plaza, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: /Jl l w °' eY

Block: 9 Residential Commercial 9 Othqrtj Name of Building: Lot: l Mix UseD # of Stories: AKA's: Building Owner/Management: T elephone Number. •1/2 lOM ) El Name: I Y FAX: Address: On Site ntkact Name: I . c4 cC4 a Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes 0 No Exterior Survey Performed ❑ Yes 0 No General Clean Up 0 Yes 0 No Locations: ACM Clean Up 0 Yes 0 No Locations: Air Monitoring ❑ Yes 0 No Locations: Copies of All Reports and Data Requested j J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes O No ❑ No Visible/Fine Layer ❑ i4 to 1 9>? South SN/A ❑ Yes 0 No ❑ No Visible/Fine Layer 2'% to 1' 0>? East R N/A ❑ Yes 0 No O No Visible/Fine Layer h to 1' D>1 West ®N/A 0Yes0No ❑ No Visible/Fine Layer Ato1' D>1' Facade Description:

Roof

Debris: to Visible /Fine Layer ❑ 6 to? [J>? Description:

Setbacks N/AI' Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1' 0>? Floor. Debris: 0 No Visible/Fine Layer ❑ y4 to 1' D>1 Floor: Debris: 0 No Visible/Fine Layer 0 % to 1' 0> 1' Floor. Debris: 0 No Visible/Fine Layer 0 3/4 to 1' 0>1' Floor: Debris: ❑ No Visible/Fine Layer [] i4 to 1' 0>1' Comments

.L Date: i 1 12002 Inspection Team: Name: _____________________Agency: Name: Agency:

NYC-WTC 000113462