WTC building inspection form, 105 Washington Street, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ( - Os ct- C`^• Block: Residential D Commercial D Name offtilmgL 7- Lot: Mix Use 0 Other 0 U # of Stories: AKA's: Building O e Manag ent: Telephone Number. )" Name: a'v~- FAX: Address: On Site Contact: Name: ' ' '' Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes io Exterior Survey Performed ❑ Yes+lo General Clean Ui3JZYes ❑ No Locations: ACM Clean Up DYes 110 Locations: Air Monitoring ❑ Yes No Locations: - Copies of All Reports and Data Requested DYes

Visual Inspection Results: Facade: Inspected Debris North /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" South /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'%to l" 0>1" East /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%tol" 0>1" West ❑ N/A ,[Yes ❑ No No Visible/Fine Layer ❑%to1" 0>1" Facade Description:

Roof

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

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 ❑'% to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer 0 % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" [] > 1"

Comments

Date: /`* /2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000113591