WTC building form, 71 Broadway, DEP Box 49

NYC 9/11 Public Portal Document

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WTC Visual Survey Form Premi a Add es ,cam Residentiic 3 Commercia Name of Building: r Block: Mix UseD ther Lot: ç \.,M Stories: AKA's: N ~` "" # of Telephone umber: (. ) S` a of f?U Building O ner/Managemnt Name: Address: i 'r On Site Contac fl ~ ~, _ ~t,..~,e,,.,r~¢,4 ~ Telephone Number. (Z Name: P Activities Building Owner Management Interior Survey Performed ,Yes ❑ No Exterior Survey Performed [ :Yes ❑ No w ►^ No Locations: U General ean Up es ACM Cieain Up [Y es❑ No Locations: es ❑ No Locations: Requested Ye Air Monitoring Co ies of Ail Re orts and Data

Visual Inspection Results: Facade: Debris inspected ❑ > 1" jNo Visible/Fine Layer ❑ +/~ to 1" North ❑ N/A . Yes ❑ No ❑% to 1" ❑ > 1" South ❑ N/A Yes ❑ No No Visible/Fine Layer Eyes ❑ No [5No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ NIA No Visible/Fine Layer ❑ % to 1" ❑ > 1" ❑NIA ~ry Yes ❑ No G ~West F cade Description:

Roof yer ❑ % to 1" 0> 1 1 Debris: Flo Visible /Fine I Description: to r A . J• " ? '~

Setbacks N/A Va to 1" . ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ isible/Fine Layer ❑' to 1 ❑ > 1" Floor: Debris: ❑ No V 1" ❑ > 1" Floor: Debris: 0 N Visible/Fine Layer ❑ % to Debris: 0 No V i sible/Fine Layer ❑ % to 1" ❑ > 1" Floor. ❑'/s to 1' >1 Floor. Debris: ❑ No Visible/Fine Layer

— '13-t' Comments e tip - C .{ ~ -

A, ~.~kc>k Chi A-. - Agency: /2002 Inspection Team: Name: Agency: Date: / Name:

ENTERED

NYC-WTC 000122479