WTC facade inspection form with debris notes, 19 Park Place

NYC 9/11 Public Portal Document

WTC Visual Survey Form Pr"raise Address: Block: Residential ommercial Name of Building: Lot: Mix Use 0 Otherfl # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) 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 Requested Yes Visual Inspection Results: Facade: Ins ected Debris North ❑ N/A [✓ Yes ❑ No ❑ No Visible me La er ~/2 to 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine ayer ❑ /s to 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /z to 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" Facade Description~

Debris: No Visible ine~ a r / to 1" 1 1" 7 Description: i~1n~~ 1bt ~~ ~c`' r~ ~,~.3 r~ i~L_

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ V2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ V2 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 ❑ Va to 1" ❑ > 1"

Date: / /2002 Inspection Team: Name: Name:

NYC-WTC-000115969