WTC Visual Inspection Form, 30 Broad Street

NYC 9/11 Public Portal Document

I WTC Visual Survey Form I000g(9 Premise Address:

Block: 2t. c

t Residential D Commercial D _4re Name of Building: Lot: 2 q Mix Use ❑ Other ❑ # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: 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 CJ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

visual inspection Kesuits: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑'/ to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑N/A E] Yes E] No o Visible/Fine Layer ❑ /2 to 1" ❑ > 1" West ❑ N/A ❑ Yes C] No o Visible/Fine Layer ❑'/ to 1" ❑ > 1" Facade Description:

Roof

Debris: Io Visible IFine Layer ❑'/to1" 0>1" Description: ff

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑'h to 1" ❑ > 1"

Comments

Date: I f /2002 Inspection by: Name: P Agency: L.if d` Name: Agency:

NYC-WTC-000118636