NYC 9/11 Public Portal Document
WTC Visual Survey Form
Premise Address:
dock esider P1Cor rcia J j Name of Building:
Lot Mix Use9 Other
S of Stories: 2. AKA's:
Building Owner/Management Telephone Number. ( )
Name: is c FAX
Address:
On Site Contact:
Name: ' ' Telephone Number.
Building Owner Management Activities
Interior Survey Performed ❑ Yes n No
Exterior Survey Performed Q Yes j] 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 DYes
visual insvection Kesuns:
Facade:
Inspected - Debris
North fl N/A Yes No No Visible/Fine Layer " to 1' >1'
South jj N/A Yes No No Visible/Fine Layer 34 to 1' "1.
East JJ N/A Yes No No Visible/Fine Layer 14 to 1' > 1'
West J N/A Yes No ~ No Visible/Fine Layer % to 1' > 1'
Facade Des ption:
Roof
Debris: E] No Visible /Fine Layer =] % to 1'
Description:
Setbacks N/A M
Floor__' Debris: No Visible/Fine Layer 34 to 1' > 1'
Floor:____ Debris: No Visible/Fine Layer 1 to 1' > 1'
Floor.__ Debris: No Visible/Fine Layer 1 to 1' > 1'
Floor. Debris: No Visible/Fine Layer 1 to1' > 1'
Floor. Debris: - No Visible/Fine Layer 34 to V >V
Comments
Date: 4- /2.7 12D02 Inspection Team: Name: p. he R. 11 gency DEP
Name: Agency:
NTERED,
NYC-WTC-000117128
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000117128Source: NYC Law Department, mirrored locally