WTC visual survey form, 23 Peck Slip, Oct 2001

NYC 9/11 Public Portal Document

tent n 1 WTCyVlsual Survey Form Premise Address: l

Block: p ResidentialU Co rnercialQ Na a of Building: Lot t47 Mix UseEl Other # of Stories: AKA's: Building Owner/Management Telephone Mimber. ( ) Name: FAX:( Address: On Site Contact: Name: " ' Telephone Number Building Owner Management Activities Interior Survey Performed Yes Q No Exterior Survey Performed Yes [] No General Clean Up Yes No Locations: ACM Clean Up Yes No Locations: Air Monitoring Yes 9 No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Ins cted Debris North s No o Visible/Fine Layer 4 to 1' a 1' South i+ Yes No No Visible/Fine Layer to 1' a 1' East N/A Yes No No Visible/Fine Layer Va to 1' > 1' West N/A Yes No No Visible/Fine Layer % to 1' H201" Facade Description:

Roof Debris: 1Vo Visible /Fine Layer .❑ Va to 1' Description:

Setbacks N/AD Floor__ Debris: No Visible/Fine Layer Va to 1 a 1' Floor____ Debris: No Visible/Fine Layer Va to 1' > 1' Floor___ Debris: No Visible/Fine Layer % to 1' a 1' Floor Debris: No Visible/Fine Layer Va to 1' a 1' Floor___ Debris: No Visible/Fine Layer Va to 1' a 1' Comments

Date: f 2-O 12002 Inspection Team: Name:_PC2 l1 !2j:j4. L D Agency: Name: a e_ Agency: ENTERE0

NYC-WTC 000115040