WTC building inspection form, 75 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential Commercial Name of Building: Lot: Mix Use D Other # of Stories: 8E AKA's: Building Owner/Management: Telephone Number: (z, ) Name: fl ,i'/S,— FAX: ( ) Address: r >-,. r. y,- (: rc :- On Site Contact: Name: / I, N - Pte- Telephone Number:; P11 Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed O Yes Ox No General Clean Up Yes O No Locations: ACM Clean Up O Yes © No Locations: Air Monitoring O Yes G] No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Kesuits: Facade: Inspected Debris North 0 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0 1,4 to 1" O> 1" South O N/A ❑ Yes ❑ No O No Visible/Fine Layer 0 1,4 to 1" ❑ > 1" East © N/A Yes ❑ No ® No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ® N/A ❑ Yes ❑ No 'O No Visible/Fine Layer O '/ to 1" ❑ > 1" Facade Description: i_' 'L- rh

Roof

Debris: Q No Visible /Fine Layer 1:J% to 1" '"' ❑ > 1" I Description:

Setbacks N/A 1 3 Floor: Debris: O No Visible/Fine Layer O% to 1" O> 1" Floor: Debris: O No Visible/Fine Layer O% to 1" O> 1" Floor: Debris: O No Visible/Fine Layer 0% to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑ Y% to 1" O > 1" Floor: Debris: O No Visible/Fine Layer ❑ Yz to 1" O> 1" Comments

Date: L/ i/ /2002 Inspection Team: Name: F h -,- ^ Z_ Agency: £ 1S C/i1 Name: I- l~L~> _ A ». Agency: -/, C oC13

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NYC-WTC 000122271