WTC building inspection form, 58 Pearl Street, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form 10 0 0013 Premise address:

Block: 7 Residential Commercial 0 Name of Building: Lot: 27 Mix Use 0 Other # of Sons: AKA's: Building Owner/Management Telephone Number: ( ) Name: Pau +1..f L•cv 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 0 Yes CJ No Locations: Copies of All Reports and Data Requested 9 Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ YesQNo ❑ No Visible/Fine Layer 034tol" 9>1" South ❑ N/A 0 YesQNo ❑ No Visible/Fine Layer 03410 1" 0>1" East ❑ N/A 0 YesQNo D No Visible/Fine Layer ❑Mato 1" 0>1" West ❑N/A DYesF]No ❑ No Visible/Fine Layer 0%to1" 0>1" Facade Description: N

Roof

Debris: JNo Visible /Fine Layer 0 V to 1" [J> 1" Description:

Setbacks N/A Floor. Debris: 0 No Visible/Fine Layer ❑'/ to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 1/2 to 1" ❑> 1' Floor Debris: ❑ No Visible/Fine Layer 0 h to 1' 0>1" Floor Debris: ❑ No Visible/Fine Layer ❑ h to 1" ❑>1" Floor. Debris: ❑ No Visible/Fine Layer [] 4 to 1" 0>1 "

Comments

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

NYC-WTC-000115454