WTC facade inspection form, 75 Broad Street

NYC 9/11 Public Portal Document I

WTC Visual Survev Form Premise Address: ~y /s QPO Sr RE L Block: 9 Residential 0 Commercial Name of Building: fl

Lot: J O Mix Use ❑ Other ❑ - N elm c.om E # of Stories: 39 AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: ( ) Address: On Site Contact: Name: J2 ,f pg4 ,• Telephone Number: ( ) Building Owner Management Mtivities 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 LI Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No & No Visible/Fine Layer ❑'/to1" 0>1" South ❑ N/A EYes Q No No Visible/Fine Layer El'/Z to 1" 0>1" East ❑ N/A Yes ❑ No ® No Visible/Fine Layer ❑%to1" ❑>1" West ❑ N/A , Yes ❑ No ® No Visible/Fine Layer ❑%to1" ❑>1" Facade Description:

Roof

Debris: ,® No Visible / ine-Layer - F1'/ to 1" 0>1" Description:

Setbacks N/A ❑ Floor: _ ; Debris: ® N> Ie/Fine Layer ❑ % to 1" ❑ > 1" Floor: 17 Debris: No Visible/Fie-Layer ❑ % to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: ? //2002 Inspection by: Name: R Agency: 7)p• Name: Agency:

I NYC-WTC-000118323