WTC debris inspection form, 105 Washington Street, Oct 2002

NYC 9/11 Public Portal Document

VVTC Visual Survey Form Premise A dress: I

Block: Residential D Commercial Name of ildi g• Lot: Mix Use Other ~k k \ - i~P~V )1--4 # of Stories: AKA's: Building O raer Manag ent: Telephone Number: ) Lj r j Name: ~, ,vim LN FAX: ( Address: On Site Contact: Name: ' * Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed ❑ Yes lo Exterior Survey Performed ❑ Yes Jo General Clean UST es ❑ No Locations: ACM Clean Up ❑ Yes 1Jo Locations: Air Monitoring ❑ Yes No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/atol" 0>1" South /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%tol" ❑>1" East 1/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%tol" 0>1" West ❑ N/A .[Wes ❑ No No Visible/Fine Layer ❑ Y2 to 1 " ❑ > 1 " Facade Description:

Roof

Debris: ❑ No Visible /Fine Layers [S to 1" ❑ > 1" i Description: < < li \ & L.. J e- S T ZJ_ 1 r ' v. l '-s-

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

Comments

Date: /_/ T?4 /2002 Inspection Team: Name: &— L Agency: j' `^" Name: Agency:

NYC-WTC 000113580