WTC building inspection form, 85 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form iO of Wremise Address: Block: / c/I Residential 0 CommercialD Name of Building: Lot: & Mix Uses Other # of Stories: 5 AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact: Name: Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes 0 No Exterior Survey Performed ❑ Yes 0 No General Clean Up ❑ Yes 0 No Locations: ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring ❑ Yes 0 No Locations: Copies of All Reports and Data Reguested Yes

Visual InsDection Results: Facade: Inspected Debris North ❑ N/A ® Yes ❑ No 0 No VisibleF r ❑%to1" 0>1" South 0 N/A Yes 0 No No Visibi ❑'h to 1" 0>1" East O N/A ] Yes O No ❑ No Visible/Fine Layer Dl6tol" 0>1" West ❑ N/A [] Yes O No ❑ No Visible/Fine Layer hto 1" 0>1" Facade Description:

Roof Debris: 10 No Visible 0 h to 1" 0>1" Description:

Setbacks N/AR Debris: 0No Visible/Fine Layer Floor. Floor. Floor: Debris: 0 No Visible/Fine Layer Debris: 0 No Visible/Fine Layer H%tol" 14 to 1" % to 1" [] >1. [] >1" 0>1" Floor. Floor. Debris: No Visible/Fine Layer Debris: No Visible/Fine Layer % to 1" 1 to 1" 8 >1" > 1" Comments

Date: c I D / 12002 Inspection Team: Name: R#1-T"7 Agency: i) P Name: Agency: -_ NTERE&

NYC-WTC 000122304