WTC visual inspection form, 104-108 Trinity Place

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~ C.

Block: Resi tial U Commerci -.- -_ j.Narne of Building: Lot: Mix Use ❑ Other ❑ # of Stories: AKA's: j t n Building Owner/Management: Telep a Number: ( ) 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

Visual Inspection Results: Facade: Inspected Debris North f jW/A ❑Yes❑No ❑ No Visible/Fine Layer ❑/2to1" 0>1" South ❑ N/A -Yes ❑ No ❑ No Visible/Fine Layer ❑/2to1" 1" East ❑ N/A 'Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" -1" West N/A ❑ Yes ❑No ❑ No Visible/Fine Layer ❑/2to 1" 0>1" Facade Description:

Roof

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

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" E)> 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 0 V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"

Comments

Date: \_/ /2002 Inspection Team: Name: ~ ~~ Agency: 91 Name: Agency:

NYC-WTC 000116610