WTC facade inspection form, 110 South Street, 2001

NYC 9/11 Public Portal Document

WTC Visual Surve Form 1 00132-7 Premise Address: l Block: g-1 Residential 0 Commercia Name of Building: Lot Co Mix UseD Other x a ' ' - # of Stories: .- AKA's: Building n rlMana amen • A Telephone Number. ( j Name: FAX: Address: On Site Contact Name: " . " 0 Telephone Number Li 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 9 No Locations: Copies of All Reports and Data Requested p Yes

Visual Inspection Results: Facade: Inspected Debris North N/A Yes No No Visible/Fine Layer i4 to 1" > 1" • South N/A Yes No No Visible/Fine Layer 34 to 1" > 1" East N/A Yes No No Visible/Fine Layer % to 1" > 1" West N/A Yes No No Visible/Fine Layer % to? 9> 1" Facade Description:

Roof Debris: No Visible /Fine Layer 936 to? 9.? Description: 1

Setbacks N/AN Floor.___ Debris:D No Visible/Fine Layer % to? > 1" Floor____ Debris: No Visible/Fine Layer 36 to 1" > 1" Floor._ Debris: No Visible/Fine Layer %to 1" > 1' Floor. Debris: No Visible/Fine Layer % to 1" 'V Floor.____ Debris: No Visible/Fine Layer %to 1" 'V Comments

Date: / 2002 Inspection Team: Name: ' '— Agency: ____ Name: Agency:.__ .ENTERED

NYC-WTC 000116866