WTC Visual Inspection Form, 15 Broad Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 3 j,j tftL-' Block: <3 Residential Q Commercial ---- 1- ,lam C- a1S ing: Lot: Mix Use Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Con 4. ~ N ~ 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 [] No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > ;" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" Facade Description: 1 / y -. -? Roof

Debris: No Visible /Fine Layer ❑ Y2 to 1" 0>1" - Descriptio : /2 .. , T T / --

Setbacks N/A ❑ 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 0 Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer 0 4 to 1" ❑ > 1"

Comments

Date: U !' /2002 Inspection Team: Name: U ' " Agency: ENTERES Name: Agency:

NYC-WTC-000118698