WTC facade inspection form, 17 Park Place

NYC 9/11 Public Portal Document

V • f WTC Visual Survey Form Premise tldress: 5' V 3 LwELR 7 B k:L7g ResidentialI Commerclaljj Name of Building: Lot Mix UseD Otherj # of S ones: AKA's: - 1 ''rl ? Q 0/l d

Building Owner/Management Telephone Number. ( ) Name: FAX: Address: ,l C€drhr NX/ 1 151 ( On Site Contact: Name: ' ' Telephone Number. Building Owner Management Activities Interior Survey Performed Yes Q No Exterior Survey Performed DYes No a

General Clean Up ❑ Yes f 1No Locations: ACM Clean Up ❑ Yes No Locations: Air Monitoring j] YesDNo Locations: Copies of All Reports and Data Requested j Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ NIA ❑ Yes ❑ No No Visible/Fine Layer 014to1 0>1' South N/A ❑ Yes ❑ No No Visible/Fine Layer ❑1 to l' 0>1* East West N/A N/A Facade Description: , BY Yes ❑ No ❑ No ( r, _ No Visible/Fine Layer No Visible/Fine Layer ❑ 6to1' ❑Ytol' 0>1' 0>1'

Roof Debris: No Visible /Fine Layer .0 14 t010 0>10 Description:

Setbacks N/A a

Floor._, . Debris: 0 No Visible/Fine Layer 14 to 1' > 1' Floor:____ Debris: No Visible/Fine Layer 3.4 to 1' >1* Floor:____ Debris: No Visible/Fine Layer h to 1' >10 Floor. Debris: No Visible/Fine Layer % to 1' > 1' Floor Debris: No Visible/Fine Layer ❑ 16 to 1' B301'

Comments

Inspection Team: Name: : Agency: Datet"°_ J f 12002 Name: Agency:

NYC-WTC-000116000