NYC 9/11 Public Portal Document
WTC Visual Survey Form I U7 $ @7
Premise Address:
S'6ez-xwe , s -reek
Block: Q Residential I Commercial Name of Building:
Lot: 1 0 Mix Use I I Other
# of Stories:q AKA's:
Building Owner/Management:i fwve- i✓ Telephone Number. (206) sG 1f -
Name: f U c.e g- eA-, bum FAX: ( ) (2(l)
Address: 4çs- S 1OO03.
On Site Contact: 13L . , -' cps . ------------------------------------------------------
Name: Toy
Building Owner Management Activities
Telephone Number: P II
Interior Survey Performed ❑ Yes ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring f I Yes ❑ No Locations:
Copies of All Reports and Data Requested Yes
visual inspection Keswts:
Facade:
Inspected Debris
North ❑ N/A Yes ❑ No 0 No Visible/F-i ie Layer ❑ /2 to 1"
South ❑ N/A Yes ❑ No 0 No Visible/Fi ❑ /2 to 1"
East ❑ N/A Yes ❑ No No Visibl r ❑ /2 to 1"
West ❑ N/A Yes ❑ No (~ No VisibleM ine-L-ager ❑ Y2 to 1"
Facade Description:
Roof
Debris: o Visible /Fine Layer I i14to 1" ❑ > 1"
Description: V1'MiA,,
Setbacks N/A
Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine .Layer ❑ /2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1"
Floor: Debris: O No Visible/Fine Layer ❑ % to 1" ❑ > 1"
I Comments
Date: 3 /2002 Inspection by: Name: R4 i i 1 A-W Agency: C .DEp.
Name: Agency:
NYC-WTC-000118956
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