WTC building inspection form, 77 Chambers Street

NYC 9/11 Public Portal Document

17 WTC Visual Survey Form Premise Address: 7) (l hf, ; l Block: Residential 0 Commercial j Name of Building: Lot: Mix UseD Otherfl _ # of Stories: AKA's: Building Owner/Management: Telephone Number: (z, ~. ) a; 3 cc s i Name: r zle-r!' i e Cc) FAX:( ) Address: - On Site Contact: Name: (i f-/k,c f ; I n - Telephone Number: (z, i ) 2 33 Building Owner Management Activities Interior Survey Performed ❑ Yes ® No Exterior Survey Performed ❑ Yes Q No General Clean Up ® Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ® No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Inspected Debris North © NIA ❑ 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 ❑'/% to 1" ❑ > 1" West 0 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer [-]'/ to 1" D>1 Facade Description: Li 'Lv -4t

Roof

Debris: ( No Visible /Fine ayer ❑ % to 1" .1 ❑ > 1" / Description:

Setbacks N/AJ Floor: Debris: ❑ No Visible/Fine Layer ❑'/a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %% to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/Z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: 1 ! `/ /2002 Inspection Team: Name: KF c Agency: Ui C~ w Name: 1 . 12 Agency: ,L.'ic Bgi,

NYC-WTC 000122279