WTC inspection form, 335/87-89/93 Broadway, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1 D (O 1 12 1 Premise Address: /f `~ ( 4.

Block: 1 7 Residential 0 Commercial Name of Building: Lot: Mix Use Other fl # of Stories: AKA's: Building Ow er/Man eme t: _ WOrk-h' S4 / TeIephon Number. (ii 31 6 &zrh Name: kALA FAX: Address: 0 On Site Con t: Name: Telephone Number. Building Owner Management Activities Interior Survey Performed DYes j o Exterior Survey Performed es [] No General Clean Up ACM Clean Up Air Monitoring 0 Yes Yes o Locations: Locations: ❑ Yes Q1Qo Locations: Copies of All Reports and Data Requested es

Visual Insoection Results: Facade: Ins acted Debris North ❑ N/A RN ❑ No Visible/Fine Layer ❑%to1" 0>1" South ❑ N/A ~~s ❑ No [5loVisible/Fine Layer ❑'/tol" 0>1" East ❑ /A es 0 No la No Visible/Fine Layer ❑~%,to1" 0>1" West [3N/A I YesDNo ❑ No Visible/Fine Layer ❑Yto1" 0>1 " Facade Description:

Roof Debris: E No Visible /Fine Layer D Va to 1" D>1" Description:

Setbacks N/A s" Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" Floor. Debris: ❑ No Visible/Fine Layer [] Ys to 1" Floor Debris: ❑ No Visible/Fine Layer ❑ a to 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 6 to 1" Floor Debris: 0 No Visible/Fine Layer [] % to 1" Comments

Date: / 12002 Inspection Team: Name: t Agency: Name: Agency: EN T E R E

NYC-WTC 000122359