Building inspection form, 125 Barclay Street, Oct 2001

NYC 9/11 Public Portal Document

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Premise Address:

Block: /. ., • Residential Commercial I Name of Building: Lot: Mix Use ❑ Other ❑ a F # of Stories: AKA's: t Building Owner/Management: elephone Number: ( ) Name: r AX:_(-- ) 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 Ir 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 ❑ Y2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer El 1/2 to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer El 1/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Floor: - Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1"

Comments t ~

Date: / /2OQ2 Inspection Team: Name: r c'L — Agency: Name: t -11 - Agency: S 4

NYC-WTC 000119414