WTC building inspection form, 23 Park Place, undated

NYC 9/11 Public Portal Document

l •r WTC Visual Survey Form Premise Address: dO fl vrry+ S¢re2"i' Block: Residential 0 Commercial J Name of Building: Lot: Mix Use Other # of Stories: ç AKA's: Building Pner an ement: Telephone Number ( ) Name: 01 r /' J 5 5oç. FAX: . Address: jvk. X)OZ On Site Contact: Name: ' ' 0 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 'D Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: • Copies of All Reports and Data Requested 0 Yes

Visual Inspection Keswts: Facade: Inspected Debris North ❑ N/A jX Yes ❑ No ❑ No Visible/F' t5e, ❑'/to1" ❑>1" South ❑ N/A ® Yes ❑ No No Visible ine ❑'/to1" 0>1" East N/A 0Yes ❑ No ❑ No Visible me Layer ❑%to 1" 0>1" West f N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" Facade Description• ' 45ys'L r , t,u~w~kws ~Et

Roof st Debris: No Visible ine yer ❑'/2 to 1" 9 ❑ > 1" ' Description:

Setbacks N/A l J _Floor. Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1" Floor: Debris: [] No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer . ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments ed . /91,. - 4..' If.

Date: Al /2002 Inspection Team: Name: fi . Fi A' ft.-C (" Agency: fJ Name: P r odv,'e t1 Agency: t YCl)

NYC-WTC-000115943