WTC facade inspection form, 75 Broad Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form (OO Q ~? J q Pre se Address: a. 75" 1P -4 D STREET Block: Residential D Commercial D Name of Building: Lot: " j 0 Mix UseD Other n ernQRpniL Ekc # of Stories: AKA's: Building Owner/Management: Telephone Number: (z! ) 9- y yG Name: 1eykuLd 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 I Yes

risuai inspecUUan mesuu ; Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'A to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ❑ YZ to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'A to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'A to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: 1?. / 2- /2002 Inspection Team: Name: Ii • R . M*W,114 J Agency: O eP . Name: Agency: N.

NYC-WTC-000118317