WTC exterior inspection form for 114 Chambers Street, July 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential El Commercial Name of Building: Lot: Mix Use E1 Otherfl # 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 0 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 ❑'/to1" South [ N/A Yes ❑ No 0 No Visible/Fine Layer [QY2to 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yto1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 1/ to 1" Facade Description:

Roof

Debris: r No Visible /Fine Layer % to 1" 0>1" Description: / t v i7—t(~- c~ R

Setbacks N/A ❑ 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: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" R> 1"

Comments

Date: O; / 0, 6 /2002 Inspection Tpam• Nnma- IL A Name: Agency: Dot._ A21-/ ?7 NYC-WTC 000121827