WTC exterior inspection form for 115 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~+ ~ ~ f t -Q `ter Block: Residential Commercial Name of Building: Lot: Mix Use El Other # of Stories: AKA's: Building O nef/ nagement: Telephone Number: (-> _ /t Name: 1p A's- 9442 FAX: ( ) X07 Address: On Site Co$ t Name: cx_S Building Owner Management Activities Ccc.e -{q, Telephone Number: ( -1 -- Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ( 'Yes ❑ No Locations: ACM Clean Up ❑ Yes o Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested El Yes

visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer []% to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Facade Description: - ,, n n I vkeA e-Vti5

Roof

Debris: Visible /Fine Layer ❑'/2to1" 0>1" Description:

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

Comments ` ' /►► x a / C+. s7

Date: ( / /2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000121876