WTC building form, 311 Broadway, DEP Box 49

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ( Q ~

Block: Residential 0) Commerci I Name of Building: CAbi Lot 31 Mix Use 0 Other # of Stories: AKA's: Building Own r/Management: Telephone Number ( ) Name: 3tl A L -C. . FAX( Address:/000 nhlvccivaL CT7 On Site Contact: Name: ' Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed (] Yes[] No General Clean Up ❑Yes No Locations: t)In ' 1 iN - ACM Clean Up ❑ Yes ] No Locations: Air Monitoring ❑ Yes[] No Locations: Copies of All Reports and Data Requested JJ Yes

Visual lnscection Results: Facade: Inspected Debris North A ❑ Yes ❑ No 9 No Visible/Fine Layer 934 to 1' > 1' South A s No 9NoVisibIeIFineLayer % to 1' >1' East N/A es No o Visible/Fine Layer h to 1' P2010 West N/A I3Yes No El No Visible/Fine Layer 034 to 1' 9> 1' Facade Description:

Roof Debris: No Visible /Fine Layer 1J % to 1 9>? Description:

Setbacks N/A 9/ Floor. Debris: No Visible/Fine Layer 936 to 1' 9>? Floor____ No Visible/Fine Layer % to 1' Floor____ Debris: No Visible/Fine Layer % to? Floor Debris: No Visible/Fine Layer 34 to 1' > 1' Floor. Debris: No Visible/Fine Layer % to 1' >1' Comments

Date: 71 Inspection Team: Name: Agency:__________ Name: Agency:

NYC-WTC 000122455