WTC Visual Inspection Form, 15 Broad Street

NYC 9/11 Public Portal Document

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.r ` ' HIITC Visual Survev Form 10 7 Premise Address: . 23 W" -- 5 M c~. Block: Residential D Commercials Name of Building: Lot: Mix UseD Other of Stories: AKA's: Building Owner/Management: Telephone Number. ( ) Name: FAX: Address: On Site Contact: / • dr. Name: Telephone Number: Building Owner Management Activities Interior Survey Performed ❑Yes 0 No Exterior Survey Performed ❑ Yes 0 No General Clean Up 0 Yes 0 No Locations: ACM Clean Up ❑ Yes No Locations: Air Monitoring [] Yes 0 No Locations: Copies of All Reports and Data Requested Dyes

visual inspection tzesuits: Facade: Inspected Debris North ❑ N/A f Yes 0 No ❑ No Visible/Fine Layer % to V ❑ > 1' South N/A Yes 0 No Q No Visible/Fine Layer va to l" 0>10 East ❑ N/A ❑Yes 0 No 0 No Visible/Fine Layer ❑ % to 1" 0 > 1" West 0 N/A 0 Yes 0 No 0 No Visible/Fine Layer 034 to 1" D> 1" Facade Description:

Roof

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

Setbacks N/A 0 Floor. Debris: 0 No Visible/Fine Layer 0 % to 1" 0>10 Floor. Debris: 0 No Visible/Fine Layer 0 4 to V 0> 1" Floor. Debris: 0 No Visible/Fine Layer j Va to 1" 0 > 1" Floor: Debris: 0 No Visible/Fine Layer DY: to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer 0> 1"

Date: 12002 Inspection Team: Name: P y14 h`-'#'✓ Agency: 06P. Name: Agency:

NYC-WTC 000118692