WTC visual survey form, 25 Peck Slip, Oct 2001

NYC 9/11 Public Portal Document

WTC VisUai Survey Form Prmise Address: • 5— a - 1 -ec ALP Block: ResidentialLi Commercial Name of Building: Lot Mix Use J 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 Q No Exterior Survey Performed Yes No General Clean Up ❑ Yes No Locations: ACM Clean Up ❑ Yes No Locations: Air Monitoring 9 Yes ❑ No Locations: Copies of All Reports and Data Requested JJ Yes

Visual Inspection Results: Facade: Inspected Debris North Ntk es ❑ No No Visible/Fine Layer 0 % to 1- fl >v South Yes No a o Visible/Fine Layer D%to1' M>r East ❑ N/A Yes No No Visible/Fine Layer ❑%to1" >1" West [) N/A Yes 0 No No Visible/Fine Layer ❑%to1" ❑>1" Facade Description:

Roof Debris: dNo Visible !Fine Layer .0 % to? 9>? Description:

Setbacks N/AE] Floor: Debris:DNo Visible/Fine Layer [] % to 1' >1. Floor. Debris: Q No Visible/Fine Layer [] % to 1' > 1' Floor. Debris: No Visible/Fine Layer %to 1' >1' Floor Debris: No Visible/Fine Layer % to 1' > 1" Floor Debris: No Visible/Fine Layer % to 1' >1'

Comments

I

Date: /2002 inspection Team: Name: Agency: Name: ENTERED.

NYC-WTC 000115044