WTC environmental inspection form, 100 Broad Street

NYC 9/11 Public Portal Document

- —_. t WTC Visual Survey Form 1 c ►o0 Z.2_ Premise Address: V , Block: Residential 0 Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: - 1 Ck i Telephone Number: Building Owner Management Activities Interior Survey Performed Q Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes Q 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 ❑%to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yto1" 0>1" East ❑N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1 " 0>1" Faca da Descnp ion.

Roof

Debris: Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks Floor. Debris: 0 No Visible/Fine Layer ❑'h to 1" 0> 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑Y:to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 1/2 to 1" ❑ > 1"

Comments

Date: 51 / /2.12002 Inspection Team: Name: _____________________Agency: -= Name: Agency

NYC-WTC 000118285