WTC facade inspection form, 101 Broad Street

NYC 9/11 Public Portal Document

VVTC Visual Survey Form Premise Address:

Block: Residential 0 Commercial Narle of Building: Lot: Mix Use D Other # of Stories: AKA's: Building Owner/M nageme t: Telephone Number: ( ) Name: C FAX: Address: On Site Contact: Name: * ' Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ 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 J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ % to 1" 0>1" Facade Description: C

Roof

Debris: ~l "o Visible /Fine Layer ❑ Y2 to V ❑ > 1" Description:

Setbacks N/A j ' Floor. DeIIS. ❑ No vsibleirine Layer ❑ h to I ❑ >1 Floor: Debris: ❑ No VisiblefFine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No VisiblefFine Layer ❑ 2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1' [3> 1" Floor: Debris: ❑ No VisiblefFine Layer ❑ i4 to 1" ❑ > 1'

Comments

Date: / i 2 OO2 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000118290