WTC debris inspection form, 43 Park Place, undated

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 4 3 L - Block: y~ Residential JJ Commercial Name of Building: Lot: lMixUseE]Other # of Stories: AKA's: Building Owner/Managa ant: Telephone Number. ( ) Name: G~r FAX: Address: to 5 - ~1~-es~.-- tl S On Site Contact Name: ' ' Telephone Number: Building Owner Management Activities Interior Survey Perfcr led ❑ Yes No Exterior Survey Performed ® Yes No General Clean Up 0 Yes ® No Locations: ACM Clean Up ®Yes ❑ No Locations:_________________________________ Air Monitoring D YesD No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris [j Yes No 0 No Visible/Fine Layer r]'4 to? ❑ > 1"- North South East 0 N/A ❑ N/A ❑ N/A ❑ Yes No ❑ Yes ❑ No D ❑ No Visible/Fine Layer ❑ h to V ❑ No Visible/Fine Layer D Ya to 1" 0>1" 0>1" West ❑ N/A ❑ Yes ❑ No 0 No Visible/Fine Layer 0 34 to 1" 0>1' Facade Description:

Roof Debris: D No Visible /Fine Layer D h to V '' " 9> V

Setbacks N/A D Floor. Debris: LJ No Visible/Fine Layer 34 to V 0>1' Floor: Debris: No Visible/Fine Layer h to 1" 0>1' Floor:____ Debris: No Visible/Fine Layer 034 to 1" ❑ > 1" Floor. Debris: No Visible/Fine Layer ❑34 to V > 1" Floor.____ Debris: No Visible/Fine Layer j] 14 to 1" D >1' Comments

Date: ~tL 12002 Inspection Team: Name: Agency: Name: Agency: S

NYC-WTC- 000115901