NYC 9/11 Public Portal Document
WTC Visual Survey Form 1 000 ' t "7
Premise Address:
jç 5 - S}'T{z E T "Jka- 6o r3r'O't Stre
Block: Residential 0 Commercial Name of Building:
Lot: tA Mix Use 0 Other
# of Stories: AKA's:
Building Owner/Management: CRC,, r°n t , LLc Telephone Number: ( ),t '3
Name:. r Mc ern FAX:
Address: 6o -o-p sTcr-T iv lovv4-
On Site Contact: 5 J . -
Name: 7e,es &ld p ' Telephone Number: ( )
Building Owner Marfgemen1 Activities
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ("ZI Yes ❑ No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring S Yes ❑ No Locations:
Copies of All Reports and Data Re uested Yes
Visual Inspection Results:
Facade:
Inspected Debris
North ❑ N/A Yes ❑ No (0 No Visible/Fine Layer ❑ % to 1" ❑ > 1"
South ❑ N/A EYes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
East ❑ N/A E Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
West ❑ N/A (j Yes ❑ No E I No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Facade Description:
Roof
Debris: EZ No le-/Fine Layer ❑ Va to 1" ❑ > 1"
Description:
Setbacks N/A ❑
Floor: L7 Debris: ® N&disible/Fine Layer ❑ Va to 1" ❑ > 1"
Floor: j g Debris: No-'islbfe/Fine Layer ❑ % to 1" ❑ > 1"
Floor: I 1 pi 4 Debris:9 No Visible/Fine Layer [ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1"
Floor: Debris: ® No Visible/FRe-L-yer ❑ % to 1" ❑ > 1"
Comments
Teresa C eri,~..r (ce ei a f zc jo 2 a, i t o Ay+SQ4 her ;b
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Sam &e t
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Date: '2—/ 21 /2002 Inspection Team: Name: kAmrew1 ' Agency:
Name: Agency:
NYC-WTC 000118407
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