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Document / 2 pages

WTC Facade Inspection Form, South Street

Machine-extracted title · confidence 85%

Visual survey form recording facade inspection results for a South Street building at the World Trade Center site.

NYC-WTC_000117186–000117187

Folder label: “4 SOUTH STREET Block: 2 Lot: 1 BIN: 1000003 Staten Island Ferry Terminal

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Scanned page image, NYC-WTC_000117186
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OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

WTC Visual QIiruau Fnrm Promise Address: L Block: esiden Commercial Name o uitding: Lot I Mix Use I I Other # of Stories: AKA's: Y v Building Owner/Management r --- Telephone Number: ( ) Name: FAX: Address: On Sits Contact Namd: Telephone .Number Building Owner Management Activities Interior Survey Performed DYes Q No Exterior Survey Performed J Yes Q No - General Clean Up DYes Na Locations: ACM Clean Up Yes U No Locations: Air Monitoring QYesD No Locations: Copies of All Reports and Data Requested Qyes

Visual inspection Results: Facade: Inspected Debris North NIA Yes No No Visible/Fine Layer 34 to 1' >1' South NIA Yes No No Visible/Fine Layer 3+4 to V > 1' East N/A Yes No No Visible/Fine Layer 34 to 1' >1' West N/A Yes No No Visible/Fine Layer 34 to 1' > 1' Facade Description: „ D n

Roof Debris: No Visible /Fine Layer .Q 34 to 1' Q> V Description:

Setbacks NIA Floor:___r . Debris: No Visible/Fine Layer 34 to 1' > 1' Floor:___ Debris: No VisibleiFlne Layer 34 to 1' > 1' floor:____ Debris: No Visible/Fine Layer Ne to 1' >1' Floor____ Debris: No Visible/Fine Layer % to 1' > 1' Floor___ Debris: No Visible/Flne Layer 34 to 1' 'l' Comments

Date: ~ j!;73ftOOZ Inspection Team: Name: ' ' Agency: Name: Agency:

NYC-WTC 000117186

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NYC-WTC_000117186Source: NYC Law Department, mirrored locally

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