WTC debris inspection form for building at 97 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential 0 Commercia1Q Name of Building: Lot: Mix Use 0 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 Q No Exterior Survey Performed [] Yes No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes t] No Locations: Copies of All Reports and Data Requested fl Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A 9YesQNo ❑ No Visible/Fine Layer D% to V 0>1. South N/A s No No Visible/Fine Layer y4 to 1' j] > 1' East N/A Yes No Visible/Fine Layer H%to 1" >1" West N/A Yes ❑ No o Visible/Fine Layer ❑ % to 1' > 1' Facade Description:

Roof ~-t Debris: 01p Visible /Fine . >e Description: t 00 1 1 f I,, ; t.Y- ~- WZc:

Setbacks NIA ❑ Floor__ Debris: No Visible/Fine Layer ❑ % to 1' Floor Debris: No Visible/Fine Layer % to V Floor___ Debris: No Visible/Fine Layer ❑ % to V Floor____ Debris: No Visible/Fine Layer % to 1' Floor Debris: ❑ No Visible/Fine Layer 34 to 1'

Comments e-'--

. iT . I Date: / + 12002 Inspection Team: Name: Agency: Name: Agency: f. `ENTERS

NYC-WTC 000122241