WTC visual survey form, 1 Peck Slip, Sept 2001

NYC 9/11 Public Portal Document

tOo 13.3 WTC Visual Survey Form Premise Address:

Block: I& Residential 9 Comma I Name of Building: Lot: 9 Mix Use 9 Other # of Stories: AKA's: 31#{ -3I j%'eI Sk 1..1q Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site' Contact ' Name: Telephone Number. Building Owner Management Activities Interior Survey Performed Yes No Exterior Survey Performed Yes No General Clean Up Yes No Locations: ACM Clean Up Yes No Locations: Air Monitoring L]Yes L] No Locations: Copies of All Reports and Data Requested p Yes

Visual Inspection Results:

Ins cted brls North Yes No J4o Visible/Fine Layer 34 to 1' > 1' South N#k es No No Visible/Fine Layer 35 to 1' > 1' East N/A Yes No No Visible/Fine Layer % to 1' >1' West N/A Yes No No Visible/Fine Layer % to 1" H30 1" Facade Description:

Roof Debris: bdNo Visible /Fine Layer -E]'K to 1' 9>1' Description:

Setbacks N/A9 Floor.___ Debris: No Visible/Fine Layer 4 to 1' >1' Floor____ Debris: No Visible/Fine Layer 34 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 34th 1' > 1'

Comments

Date: F/ O I2OO2 Inspection Team: Name: O -\ Agency. T E E Name: Agency:

r NYC-WTC- 000115054 ~~~