WTC Survey Form, 24 Beaver Street

NYC 9/11 Public Portal Document

100003S WTC Visual Survey Form Premise Address: 2 %i 1L 51. Block: fl Residential Commercial LI 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 ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Facade Description: Ali Ar

Roof

Debris: ❑ No Visible /Fine Layer R'/2 to 1" 0>1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer fl '/z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"

Date: I- /1/2002 Inspection by: Name: Agency:) `'t.VC r Name: Agency:

NYC-WTC-000119147