Visual survey form, 68 Trinity Place

NYC 9/11 Public Portal Document

A.' WTC Visual Survey Form A

Premise Address: ,,--c _ 0

Block: çi Residential 0 Commercial Name of Building: Lot: L.. Mix Use J Other # of Stories: AKA's: Building Owner/Management: vf i - Telephone Number: ( ) Name: c~ N 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 f J Yes

Visual Inspection Results: Facade: Inspected Debris North N/A ,❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" South . -N/A g: ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" East ' . 'Yes ❑ No to Visible/Fine Layer ❑ / to 1" West /A. ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer n% to 1" 0>1" Description:

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

Comments C% ' ... C—tk/A f h Aj

Date: Inspection Team: Name: ~` t Agency: L~'T'' Name: Agency:

NYC-WTC 000116780