WTC building inspection form, 41 Park Row, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form lOot35(o Premise Address: p Block: ® Residential Commercial Name of Building: Lod Mix Use Other # of ories: AKA's: Building Owner/Management: Telephone umber. ( ) 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 ❑ Yes ❑ No Locations: Copies of All Reports and Data RequestedD Yes

Visual Inspection Results: Facade: Inspected Debris North 0 N/A ❑ Yes 0 No No VSible/Fine Layer ❑ 4 to 1" 0>1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ % 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" ❑ > 1" Facade Description:

Roof

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

Setbacks N/A ❑ 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 ❑ 34 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ h to 1" ❑ > 1"

Comments

Date: _ Ijjj2OO2 Inspection by: Name: C1 L* Agency: Name: Agency:

NYC-WTC-000115444