WTC building inspection form, 291 Broadway, Feb 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form too I (o'I9 Premise Address: (o Qk1G ST Block: 150 Residential 0 Commercial J Name of Building: Lot: Mix Use J Other # of STór es: AKA's: POjyz Lie Building Owner/Management Telephone Number. ( Z/24 (ô - -Z - Name: FAX: Address: On Site Contact `D.e. 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 Inscection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No ® No Visible r ❑Yztol" 0>1" South ❑ N/A 0 Yes ❑ No &No Visible ❑vtol" 0>1" East N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to r 0>1" West 2 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ a to l" 0>1" Facade Description:

Roof

Debris: J@ No Visible r ❑ % to 1" ❑ > 1" Description:

Setbacks N/A 54 Floor. Debris: ❑ No Visible/Fine Layer ❑ 3. to 1" 9>1" Floor. Debris: ❑ No Visible/Fine Layer 93.4 to 1" 0>1" Floor: Debris: ❑ No Visible/Fine Layer 0 Va to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" D> 1" Comments

Date: _ / /0.12002 Inspection Team: Name: Parrr-rY o l- 'vi Agency: Name: Agency: ENT EREQ

NYC-WTC-000122433