WTC building inspection form, 279 Broadway, Feb 2002

NYC 9/11 Public Portal Document

SI .. WTC Visual Survey Form I Premise Address: 7 eADG- s-r J5 Block: I l Lot: 4 Residential 0 Mix UseD Commercial p Other 0 Name of Building: /3 # ofstories: AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact Name: • • Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up 0 Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes visual Inscection Results: Facade: Inspected Debris North 0 N/A ,E Yes ❑ No [R No Visiblelf er ❑%tol" 9>1" South N/A Yes ❑ No allo Visible1 " ar ❑%tol" ❑>1" East N/A fl YesoNo ❑ No Visible/Fine Layer ❑'vatol" 0>1" f N/A ❑ Yes Q No a

West D No Visible/Fine Layer ❑Ytol" []>1" Facade Description:

Roof Debris: No Visible 934to1" 9>1" Description:

Setbacks N/A to Floor. Debris: 0 No Visible/Fine Layer ❑ h to 1' 0>1" Floor Debris: ❑ No Visible/Fine Layer 934 to 1' > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" 9> 1" Floor Debris: [] No Visible/Fine Layer ❑ 4 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: I/o 12002 Inspection Team: Name: irztc,/ta.it

Agency: Name: Agency: ENTERED

NYC-WTC 000122425