WTC exterior inspection form for 114 Chambers Street, July 2002

NYC 9/11 Public Portal Document

' WTC Visual Survey Form Premise Address:

Block: Residential Q Commercial 0 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 0 Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up 0 Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested J Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 6 to 1" 0>1" South 13N/A I Yes ❑ No 0 No Visible/Fine Layer [a'/ to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description:

Roof

Debris: R. No Visible /Fine Layer , ❑ % to 1" ❑ > 1" Description: i,~,~sP~t [C- W-6," ~, I gs

Setbacks N/A ❑ Floor: Debris: 0 No Visible/Fine Layer ❑ .4 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 0 % to 1" ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ >V

Comments

Date: t/ / /2002 Inspection Team: Name: A L— Agency: Name: ___________________Agency: Nen; lcn_

A .H Ry NYC-WTC 000121829