WTC building form, 80 Broadway, DEP Box 49

NYC 9/11 Public Portal Document

WTC Visual Survey Form B IJ 1000 8I S Premise Address: B® Broad coax I wa I I Sree°~ Block: 23 Residential 0 Commercial 0 Name of Building: Lot: 7 Mix Use D Other # of Stories: 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 ❑ Yes ❑ No Locations: ACM Clean Up 0 Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested I I Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑Yto1" 0>1" South ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑Yto1" 0>1" East ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑%tol" 0>1" West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑%tol" 0>1" Facade Description:

Roof

Debris: o Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑ V 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 ❑ 1/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"

Comments

Date: o9 / c /2002 Inspection by: Name: AP Agency: D6P Name: Agency:

NYC-WTC 000122490