WTC building inspection form, 19 Park Place, undated

NYC 9/11 Public Portal Document

- ~a WTC Visual Survey Form Premisb Address:

Block: Residential9 Commercial Name of Building: Lot:. # of Stories: Mix Use AKA's: I Building Owner/Management: IJ Other g rt (ai2 e 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 J Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A ❑ No ❑ No Visible ine La er ~/to1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine yer ❑%to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" Facade Description:

Roof ~

Debris: No Visible ine r '/ to 1" •? ~ 'l" '~ Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer 0 Ya to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: t] No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Date: ~ / /2002 Inspection Team: Name: Agency: 5t✓ P Name: Agency:

NYC-WTC-000115992