Facade inspection form, 40 Peck Slip, Oct 2001

NYC 9/11 Public Portal Document

WTC s Isugi1 Survey Form Premise Address: r€~ t) Block: Residential 9 Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact: Name: ' ' Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes D No Exterior Survey Performed Yes ❑ No General Clean Up ❑ Yes No Locations: ACM Clean Up Yes No Locations: Air Monitoring Yes[] No Locations: Copies of All Reports and Data Requested DYes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A fl Yes No No Visible/Fine Layer 9 3 4 to 1' D>1 South [ es No No Visible/Fine Layer %to V ❑> 1' East es No No Visible/Fine Layer h to 1 0>1' West ❑ N/A 9Yes No No Visible/Fine Layer ❑Yto1' ❑>1' Facade Description:

Roof Debris: [+llo Visible/Fine Layer .9 341o 1' 9>1' Description:

Setbacks N/AL] Floor: Debris: No Visible/Fine Layer ❑ % to 1' > 1' Floor: Debris: No Visible/Fine Layer [] 4 to V >1' Floor: Debris: No Visible/Fine Layer 4 to 1' > 1' Floor: Debris: No Visible/Fine Layer % to 1' > 1' Floor: Debris: No Visible/Fine Layer 36 to 1' g > 1' Comments

Date: I " W 12002 Inspection Team: Name: Agency: ENTERED Name: Agency:

NYC-WTC 000115022