WTC building inspection form, 17 Park Place, undated

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: )(ç Commercial ac l Name of Building: Block: Residentia 0 Lot: Mix Use E3 Other ❑ # of Stories: 4 AKA's: Building Own anag ment: Telephone Number: ( ) Name: f I i4t4 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: Inspected North ❑ N/A ❑ No sible/Fine Layer ❑ 1/2 to 1" South ❑ N/A bres ❑ No M sible/Fine Layer ❑'h to 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" West ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine ayer ❑'/2 to 1" . `'L'"'~ ❑ > " •1 Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 % to 1" ❑ > 1"

Comments

Date: /2002 Inspection Team: Name: _ Agency: Name: Agency:

NYC-WTC-000115995