WTC building form, 75 Broadway, DEP Box 49

NYC 9/11 Public Portal Document

WTC Visual Surrey Form Premise Ad ,s:

Block: Residential Com a dial Name o Buildin~: Lot: Mix Use Other. (4 # of Stories: AKA's: Building Own r/Mana ment: Telephone Number: (71z)G~Z ~. ~ Name: 04 'iorteto FAX: ( ) Address: On Site Contact: Name: c: 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 Inspection Results: Facade: Inspected Debris North ❑ N/A Q4YesDNo -V_No Visible/Fine Layer ❑'/ to 1" 0>1" South ❑ N/A DYes ❑ No No Visible/Fine Layer ❑'/z to 1" 0>1"1- East ❑ N/A ❑ Yes ❑ No No ViSible/Fine Layer F]Y2 to 1" ❑> 1" West ❑ N/A Yes ❑ No No Visible/Fine Layer ❑Y to 1" 0>1" Facade Description:

Roof i yt

Debris: No Visible /Fine r ❑'/ to 1" •1 ❑ > 1" '1 Descriptio >r S ~ Wj

Setbacks N/A Floor: Debris: VNo Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris:. No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: [ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris:,] No Visible/Fine Layer ❑ %z to 1" ❑ > 1"

Comments

Date: 1/2/2002 inspection Team: Name: 1 L.-~~~ t Agency: / "n Name: Agency:

15 NYC-WTC 000122483