WTC building inspection form, 385 South End Avenue

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~~~' 3(5ç ~"~'e. Block: Residential 0 Commercial j 1 Name of Building: Lot: Mix Use Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: V FAX: ( ) Address: On Site Contac Name: - f-ca S Telephone Number: 2 ) Building Owner Management Activities Interior Survey Performed [ Yes ❑ No Exterior Survey Performed DYes ❑ No General Clean Up [.Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring Q -Yes ❑ No Locations: Copies of All Reports and Data Requested Q Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Q'Yes ❑ No ❑ No Visible/Fine Layer ❑'/a to l" 0>1" South ❑ N/A 9Yes ❑ No ❑ No Visible/Fine Layer ❑'/a to l" 0>1" East ❑ N/A EYes ❑ No ❑ No Visible/Fine Layer ❑%a to 1" 0>1" West ❑ N/A -9Yes ❑ No ❑ No Visible/Fine Layer El%2 to 1" 0>1" Facade Description:

Roof Lti Debris: ] No Visible /Fine tayer ❑ / to 1" •1 ~"`' ❑ > 1" 1 Description:

Setbacks N/A , Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: _/ x/2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC-000117631