WTC facade inspection form, 124 Water Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Addres 1Z ( a ,~ 4 -

Block: Residential 10 Commercial 0 Name of Building: Lot: 13 Mix Use 0 Other # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact: U ~/ Name: - i ~.t1& a ne Number: Building Owner Management Activitie Interior Survey Performed ❑ Yes [No Exterior Survey Performed [ ((es ❑ No General Clean Up ❑ Yes a" o Locations: ACM Clean Up ❑ Yes~~o Locations: Air Monitoring ❑ Yes [3No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North 9'N/A fes ❑ No ❑ No Visible/Fine Layer ❑ h to 1" ❑ > 1" South [ l/A es ❑ No ❑~,~ Visible/Fine Layer ❑/2tol" ❑>1" East ❑ /A QYesDNo IB No Visible/Fine Layer ❑/ato1" 0>1" West QN/A &'es❑No ❑ No Visible/Fine Layer ❑Yato1' 0>1" Facade Description:

Roof

Debris: eNo Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' ❑ > 1' Floor. Debris: [] No Visible/Fine Layer ❑ % to? ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/:to? ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to V ❑ > 1" Comments

Date: A') /2002 Inspection Team: Name: Agency: U~ Name: Agency:

NYC-WTC 000113678