WTC debris inspection form, 52 Beekman Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Addre : -

Block: q Residential ~. Commercial Name of Building: Lot: 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 ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ 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 %t01" ❑>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Y2to1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer %to 1" 0>1" Facade Description:

Debris: ❑ No Visible /Fine Layer X V2 to 1" 0>1"

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 ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: / /2002 Inspection by: Name: _ j.. Agency: Name: Agency:

NYC-WTC-000118829