NYC 9/11 Public Portal Document
WTC Visual Survey Form
•Premise Address:
Block: 7 ResidentialD CommercialD Name of Building:
Lot: 7 Mix UseD OtherjJ
# of toes: AKA's:
Building Owner/Management: A Telephone Number. ( ) V
Name: v cJLoS 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 0 No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested p Yes
Visual Inspection Results:
Facade:
North [] N/A
Inspected
Yes ❑ No
Debris
No Visible/Fine Layer 9 i4 to 1' H:,.iw
South ❑ N/A Yes ❑ No ] No Visible/Fine Layer ❑ % to 1' > 1"
East ❑ N/A DYestJNo No Vsible/Fine Layer ❑ % to l' 0>1'
West ❑ N/A CJ Yes ❑ No HNoVeible/Fine Layer ❑ h to l' 0>1'
Facade Description: j f - ()
Roof
Debris: -N'o Visible /Fine Layer 914 to 1' j] > 1'
Description:
Setbacks N/A l "
Floor. Debris: ❑ No Visible/Fine Layer 1 to 1' >1'
Floor Debris: ❑ No Visible/Fine Layer 14 to 1' > 1'
Floor. Debris: ❑ No Visible/Fine Layer h to 1' > 1'
Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1'
Floor. Debris: ❑ No Visible/Fine Layer 914 to 1" D>1'
Comments
Date: I 1 12002, Inspection Team: Name: ( — Agency:_______
I Name: Agency:
NYC-WTC 000113625
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