WTC debris inspection form for building at 97 Chambers Street

NYC 9/11 Public Portal Document

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WTC Visual Survey Form Premise Address:

Block: Residential 0 Commercial p Name of Building: Lot: Mix Use EZI Other I eE ~cE # of Stories: S AKA's: Building OwnerlMan Bement: Telephone Number: (t,2. ) .k 4.3 -5) . Name: t !)EC FAX: Address: w / S1 . + On Site Contact: Name: C'i-PRr" /-Ar.-.; CA - Telephone Number: (2,L ) = 3r;.:. Building Owner 'Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed 0 Yes Q No General Clean No Locations: : ~: . ' "_ .t - ACM Clean UpUpByYees0EjNo Locations: Air Monitoring D Yes 0 No Locations: Copies of All Reports and Oata Requested Yes

Visual Inspection Resui : Facade: Inspected Debris North NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1' South ❑ N/A j] Yes ❑ No Q No Visible/Fine Layer ❑ % to 1" ❑ > 1" East [Q N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0'h to 1" ❑ > 1" West Q N/A Yes ❑ No j] No Visible/Fine Layer 0'/ to 1" ❑ > 1" Facade Description: f.

Roof N ~• >A ❑ > 1" Debris: ❑ No Visible 1FineLayer Q'/ to 1" •7 /iY Description: c; -!, ti . 1r /,. iK %./Cnr fib. ! rti✓SI/'

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" 0> 1" Floor. Debris: [] No Visible/Fine Layer ❑'% to 1" 0> 1" Floor: Debris: [] No Visible/Fine Layer 0% to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %to 1" 0>11 Floor. Debris: ❑ No Visible/Fine Layer ❑ Ya to V F]> V

Comments

Date: 13 " 12002 Inspection Team: Name: 1, ! 'Z ; .< r F r. 4 Agency: Name: ic, 4r~,..' < .y•' Agency: y~r' 2p 7`

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NYC-WTC 000122258