WTC exterior inspection form, 21 Ann Street, June 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 21 ANN S --re aT Block: go Residential 0 Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: z AKA's: Building Owner/Management: 2I 4N Sr. C - ' Telephone Number. (2 iz) 2s-r- 9r6o 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 Yes

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Facade: Inspected Debris North N/A Yes ❑ No ❑ No Visible/Fine % to 1" 0>10. South fl N/A RYesE] No ❑ No Visible/Fine Layer Layer~%tol' 0 ❑ > 1" East N/A ❑ Yes ❑ No gNo Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" West J4 N/A PaYes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description: 'DE'BW S' cooNb • oN 110 W 20NTAL t r c Es

I Roof

Debris: ❑ No Visible /Fine Layer ''/2 to 1" ❑ > 1" Description:

Setbacks N/A$ Floor Debris: [)No Visible/Fine Layer ❑ Y2 to 1" ❑ >V Floor. Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 10 Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑> V Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer 0 to 1" ❑ > 1"

I Comments

Date: _/ (I /2002 Inspection Team: Name: T bi / Ao2•o Agency:NYc t P Name: Agency:

NYC-WTC- 000116512