WTC building inspection form, 97 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:'

Block: Residential Commercial f J Name of Building: Lot: MixUse 1 Other ❑ # of Stories: 5 AKA's: — Building Owner/Management: Telephone Number: (-L, z. ) 3 -S'>- Name: r l)t t FAX: ( ) Address / -'~ '' '- -s.-, On Site Contact: Name: r! rr 1 ' -. 1; r « - Telephone Number: (2i L) a Building OwnerManagement Activities Interior Survey Performed ❑ Yes © No Exterior Survey Performed ❑ Yes ] No General Clean Up Q Yes ❑ No Locations: .-; r- -- ACM Clean Up ❑ Yes Ij No Locations: r

Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

VISUdI If1SpUI. LIUIl rnaauiw.

Facade: Inspected Debris North ❑a N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" South ❑ N/A [D Yes ❑ No Q No Visible/Fine Layer ❑'/z to 1" ❑ > 1" East M N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" West E] N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Facade Description:

Roof gj

Debris: ❑ No Visible /Fine tayer ❑'h to 1" 1 {"'''~ ❑ > 1" 1 Description: S, / . ; n . ,,: i, J'-":,. ;hyS f' .,

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

Comments ` If• C' $ / '✓rt ' / r

Date: /__ /2002 Inspection Team: Name: IL_ ' _ ' ; _/I , 4 Agency: L Name: ;'-, / - r .;1io v 7•.. Agency: ~~ `~ 1. /)c C'.'

39 NYC-WTC 000122265