WTC Facade Inspection Form, 25 Bridge Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: n.-

Block: Residential `Commercial Name of Building Lot: Mix Use 0 Other # of Stories: AKA's: Building OwnerlMan ement: ;_ , , Telephone Number: rli C 1 Name: u `.,f~.. 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 Q 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 ❑htol" 0>1" South Q N/A ❑ Yes Q No ❑ No Visible/Fine Layer ❑%to1" 0>1" East ❑ N/A Q Yes Q No Q No Visible/Fine Layer ❑ Y2 to 1" 0>1" I - West ❑ N/A Q Yes Q No ❑ No Visible/Fine Layer I-]% to 1" 0>1" Facade Description:

Roof

Debris: 'No Visible /Fine Layer 0'Y2 to 1" 0>1" Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer Q Y2 to 1' ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer ❑ !2 to 1" 0>1' Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: Q No Visible/Fine Layer ❑ %% to 1" ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1' Comments

Date: / /2002 Inspection Team: Name: Agency: Name: Agency: E> i r

NYC-WTC 000118658