WTC Building Inspection Form, 17 Battery Place

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: L C

Block: esidential Co mercial Name of Building: Lot: Mix Use Other # of Stories: I AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: Tele hone Number: (z. • ) 3 ~'~-~ Building Owner Management Activl s Interior Survey Performed ❑ Yes o 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 [3%a to 1" 0>1"1- South ❑ N/A ❑Yes ❑ No ❑ No Visible/Fine Layer El '/a to 1" 0>1" East ❑ N/A es❑No ❑ No Visible/Fine Layer to 1" 0>1" West ❑ N/A ❑Yes❑ No ❑ No Visible/Fine Layer '/2 to 1" 0>1 Facade Description:

Roof

Debris: 1lo Visible (Fine Layer ❑'/ to 1" ❑ > 1" Description{

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor: Debris: j] No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: ,30 0 Inspection Team: Name: Agency: N T E Name: Agency:

NYC-WTC-000119246