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

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: --- Z ,~ 7 Block: Residential Commercial Name of Building: Lot: Mix Use ❑ Other # of Stories: AKA's: Building Owner/Manag men : Telephone Number: ( - ) ~~- -L ; 1 Name: 1. ~ FAX: Address: On Site Contact• o 3 Name: ~~,~.~ L&v Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed 0 Yes ❑ No Exterior Survey Performed [3 Yes ❑ No General Clean Up [Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring [2 Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

•IDUdI uII J uvn r%WbUIL . Facade: Inspected Debris North ❑ N/A LYes ❑ No No Visible/Fine Layer ❑'/z 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 ❑'/2 to 1" ❑ > 1" West ❑ N/A DYes ❑ No No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Facade Description: L ' L- . s Zti

Roof

Debris: ❑ No Visible /Fine ayer 0 '/2 to 1" .7 t E > 1" 1 i "'~ Description:

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

Comments

Date: /2- ' /2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000114109