File cover sheet or label, 200 Rector Place, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential Commercial Name of Buildng: Lot: Mix Use El Other El _______ c,o o ii,U , #of Stories: 3 AKA's: Building Owner/Manag men : Telephone Number: ( z -73 I U Name: L \ ,ç ' FAX: ( ) Address: On Site Contact• Lo-%Q- — Name: ~1,t.~.5 ,0 L&V Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed ® Yes ❑ No Exterior Survey Performed ❑'Yes ❑ No General Clean Up EYes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring E'Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected ebris North ❑ N/A DYes ❑ No No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" South ❑ N/A DYes ❑ No No Visible/Fine Layer ❑ 1/2 to 1" ❑> 1" East ❑ N/A ® Yes ❑ No No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" West ❑ N/A DYes ❑ No No Visible/Fine Layer ❑ %2 to 1" 7> 1" Facade Description: Pp,, t-;. ' K.'

Roof . Debris: ❑ No Visible /Fine ayer ❑ Y2 to 1" •1 ~"' ~> 1" 1 Description-

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

Date: ~ / 2- ' /2002 Inspection Team: Name: Agency: Name: — Agency: ! - 1° V

NYC-WTC- 000114107