WTC visual survey form, 1 Peck Slip, Sept 2001

NYC 9/11 Public Portal Document

Jw WTC Visual Survey Form 1 013(003 Premise Address: 1-1 y PEC -CL-? Pa PECt S'L t P Posr OFFlcE Bloc Residential Commercial f 1 j4ame of Building: Lot: Mix Use j J Other US S. # of tories: AKA's: Building Owner/Management: Telephone Number: ( ,.. 17 6 tf.-10 ul Name: ,tom - 4,.; FAX: ( ) Address: On Site Contact: ,-~ R ,A jvc.E srC-P s, ~r irn 1 cr Name: LJ Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ® Yes ❑ No Locations: ML._ -S ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes. ❑ No Locations: Copies of All Reports and Data Requested 1 j Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A ® Yes ❑ No No Visible/Fine Layer ❑%to 1" South ❑ N/A ®'Yes ❑ No No Visible/Fine Layer ❑ % to 1" East ❑ N/A ® Yes ❑ No ®'No Visible/Fine Layer 0 1/2 to 1" West j N/A gYes ❑ No No Visible/Fine Layer ❑ % to 1" Facade Description:

Roof

Debris: KNo Visible /Fine Layer ❑ % to 1" 0>1" Description:

Setbacks N/A X Floor Debris: ❑ No Visible/Fine Layer ❑ Y2 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 ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: 2- / I /2002 Inspection Team: Name: f1'fl '' Agency: /milc 1 EP Name: Agency:

NYC-WTC-000115059