WTC debris inspection form: 170 Broadway, Oct 2000

NYC 9/11 Public Portal Document

WTC Visual Survey Form Promise Address:

Block: ResidentialD Commercial 9 Name of Building: Lot Mix Use Other # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact Name: 4vf - GJ- Telephone Number. 2/2. Z _ Building Owner Management Activities Interior Survey Performed Q Yes Q No Exterior Survey Performed ❑ Yes ❑ No General Clean Up Yes 0 No Locations: ACM Clean Up Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested J Yes

visual inspection Kesuns:

Inspected Debris North Q N/A Q Yes Q No ❑ No Visible/Fine Layer 0 V to? L] > 1" South Q N/A ❑ Yes No ❑ No Visible/Fine Layer 0 Va to 1" ❑ > 1" East ❑ N/A ❑Yes0 No Q No Visible/Fine Layer ❑ % to 1" 0> 1" West Q N/A Q Yes ❑ No ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Facade Description:

Roof

' Debris: CZNo Visible r L] ih to? L] > 1" Description:

Setbacks N/A[] Floor. Debris: Q No Visible/Fine Layer 9 V to 1" 0> 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y: to 1" 0>1 Floor. Debris: Q No Visible/Fine Layer ❑ 34 to? 0>1" Floor. Debris: Q No Visible/Fine Layer h to? 1" Floor. Debris: ❑ No Visible/Fine Layer 34 to? ❑> 1"

Comments

Date: 3 l .2.3 /2002 Inspection Team: Name: Name: R O ^'V Agency: O &P. Agency:

NYC-WTC 000122560