WTC exterior inspection form, 21 Ann Street, June 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 2l ANN S-re~ -r- Block: 90 Residential 0 Commercial Name of Building: Lot: at Mix Use 0 Other # of Stories: z AKA's: Building Owner/Management: 21 ANN Sr. C~p Telephone Number. ( 21z) 26-r- 9TO 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 0 Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

visual inspecuon rcesuuus: Facade: Inspected Debris North N/A Yes ❑ No ❑ No Visible/Fine Layer 'W 'A to 1" ❑ > 1". South tj N/A RYesE] No ❑ No Visible/Fine Layer ❑'r4 to 1" ❑ > 1" East N/A ❑ Yes ❑ No gNo Visible/Fine Layer ❑ / to 1" ❑ > 1" West 14 N/A PlYes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description: - • - DE8tz15 GooND ON !'&O ?Or' T L I:EDGEs

Roof

Debris: ❑ No Visible /Fine Layer P'h to 1" '' ❑ > 1" Description:

Setbacks N/AX Floor Debris: ❑ No Visible/Fine Layer ❑ r4 to V ❑ >V Floor Debris: ❑ No Visible/Fine Layer ❑'/% to V ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 /2 to V ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 0 to V ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

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Date: 06 12002 Inspection Team: Name: bA / A02-•o Agency: NYC CP Name: Agency:

NYC-WTC- 000116503