NYC 9/11 Public Portal Document
J
WTC Visual Survey Form /COI/y(
Promise Address: •
Block: Residential p Commerclar J Name of Building:
Lot: Mix Use 0 Other
# of Stories: AKA's:
Building Owner/Management: Telephone 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 YesL J No Locations:
Copies of All Reports and Data Requested Yes
Visual Inspection Results:
Facade:
Inspected Debris
North N/A Yes No No Visible/Fine Layer 34 to 1' >1'
South N/A Yes No No Visible/Fine Layer 34 to? >1'
East N/A Yes No No Visible/Fine Layer 34 to 1' >1'
West N/A Yes No H~vo Visible/Fine Layer 34 to 1' >1'
Facade Description: 0 n _
RS ..
Debris: ~ible /Fine Layer .934 to 1'
Description:
Setbacks N/A
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 34 to? >1'
Floor:_,_ " Debris: No Visible/Fine Layer 36th 1' >1'
Floor: _ Debris: No Visible/Fine Layer 34th 1' >1'
Comments