WTC Facade Inspection Form, South Street

NYC 9/11 Public Portal Document

WTC Visual Survev Form Premise Address:

Block: I Residential 0 Commercia Name of Building: Lot Mix Use Other # of Stories: I AKA's: uiiding Owner/Management Telephone Number: ( ) Name: G FAX Address: On Site Con Namd: ' ' Telephone .Number Building Owner Management Activities Interior Survey Performed DYes 0 No Exterior Survey Performed DYes No General Clean Up Yes No Locations: ACM Clean Up J Yes 0 No Locations: Air Monitoring QYes No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris North N/A Yes Na No Visible/Fine Layer 34 to? > 1' South N/A Yes Na No Visible/Fine Layer % to 1' > 1' East N/A Yes Na No Visible/Fine Layer 34 to V > i' West N/A Yes No No Visible/Fine Layer A to Y > 1' Facade Description: „ ~1

Roof Debris: t~No visible !Fine Layer .934 to? ❑> 1' Description:

Setbacks WAK Floor __•_ . Debris. No Vlsible/Fine Layer Ne to 1 >1 Floor:____ Debris: No Visible/Fine Layer % to? > 1' Floor:____ Debris: No Visible/Fine Layer 34 to 1' > 1' Floor_ Debris: No Visible/Fine Layer h to? >1' Floor:__ Debris: No Visible/Fine Layer % to 1' > 1'

Date: ? O2 Inspection Team: Name: ~' C Agency Name: Agency

NYC-WTC-000117188