Site identification list, 22 Thames St

NYC 9/11 Public Portal Document

WTC Visual Survey Form s Pr emise Address: 12 \kPw Block: Residential J CommerciaF Name of Buildin : Lot: Mix Use ❑ Other ❑ C, # of Storie : AKA's: ~~ 6v e Buildin wn r/M agement: Telephone Number: ( 2i Z) a(, , ( Address: On Site Contact. I Name: > V e wi~ Telephone Number: (Z,ti ) 3D A l()3 Building Owner Managemen Activities Interior Survey Performed es ❑ No Exterior Survey Perfo ed "-Yes ❑ No General Clean Up lYYes ❑ No ' Locations: ACM Clean Up ❑ Yes o Locations: Air Monitoring ❑ Yes. No Locations: Copies of All Reports and Data Requested es

Visual Inspection Results: Facade: Inspected Debris North MN/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to I" ❑ > 1" South 'N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" East ❑ N/A RIYes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ' 1" West ❑ N/A J Yes ❑ No ❑ No Visible/Fine Layer ❑'h to 1" 1ZI> 1" Facade Description: ~~ry

Roof

Debris: ❑ No Visible /Fine ayer ❑ /2 to 1" i~'"' > 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: \I Z /2002 Inspection Team: Name: 'k'— '~lit Agency: — = Name: Agency:

NYC-WTC 000116134