WTC exterior inspection form for 112-114 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: I Block: Residential D Commercial p Name of Building: Lot: Mix Uses Other # of Stories: t 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 vtsuai inspecuon r~esunz; Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer D'/tor 0>1" South ["N/A (-Yes ❑ No ❑ No Visible/Fine Layer [✓ 112 to 1 ' 0 >1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑hto1" 0>1" Facade Descnption: K ~)~-s '' c,~ "tomM nc ►+.~~C.$

Roof

Debris: Q No Visible /Fine Layer ❑ % to 1" ❑ > 1" Description: I /-~...& ,

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No VSible/Fine Layer []% to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 03410 1" ❑ > 1" Comments IL

Date: Ol/ /2002 Inspection Team: Name: A L— Agency: Name: ___________________Agency: Po L,

NYC-WTC 000121862