WTC building inspection form, 83 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form loot G~2 Pr.niise Address: Rye Block: 14 l Residential 0 Commercial 0 Name of Building: Lot: 5 Mix Use Other X # of Stories: S" AKA's: 13 Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact . . 7e t ®mod d sDr . Name: ' ' Telephone Number Building Owner Management Activities Interior Survey Performed Yes ❑ No Exterior Survey Performed [] Yes ❑ 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 0 N/A ® Yes ❑ No El No Visible/ ay ❑ % to 1" ❑ > 1" South ❑ N/A E Yes ❑ No o Visible ❑ a to 1" ❑ > 1" East ❑ N/A [] Yes ❑ No RoVisible/Fine, Layer ❑ % to l" [J>1" West ❑ N/A ❑ Yes Q No ❑ No Visible/Fine Layer ❑Y= to 1" 0>? Facade Description:

Roof Debris: No Visible 034t01" 0>? Description:

Setbacks N/A 0 Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to V 0>1' Floor. Debris: ❑ No Visible/Fine Layer 04 to? ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer % to? >V Floor. Debris:[I No Visible/Fine Layer h to 1" ❑ > 1" Floor Debris:[] No Visible/Fine Layer % to? 0>1' Comments

Date: c/of 12002 Inspection Team: Name: RA-rv? Agency: ). &p Name: Agency: ENTERED

NYC-WTC 000122301