WTC debris inspection form: 173 Broadway, Oct 2000

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: - 17 3 /3cc r w 2 if' 51. Cod, f.*.J54 ff & f Block: I lesidential 0 Commercial I Name of Building: Lot: dI Mix Use ® Other 0 f fl /d -e g j C A"2 2. # of Stories: 2.. I AKA's: Building Owner/Management: lephon Number:1, Pl l Name: A t fri fS4'fIt,;,.j FAX:( ) ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._. Address: On Site Contact: o f p&i.e'i.a Name: " t it '1 //,'o, ,v - Telephone Number: { Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No .- General Clean Up Yes ❑ No Locations: ;k iQoo1 ACM Clean Up U Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested J J Yes

visual inspection Results: Facade: Inspected Debris North ®,N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%tol" ❑>1" Yes ❑ No ❑ No Visible/Fine Layer South East West I N/A N/A Ig N/A Yes ❑ No ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ No Visible/Fine Layer ❑%to1" >1" ❑%to1" ~>in ❑%to1" ❑>1" Facade Description: _, AE

Roof Wst Debris: ❑ No Visible /Fine tayer ❑%:to 1"•1 =- 50 > 1" .1 ;:"• Description: .& mf< . AMa d..4h o Vi /r C '' *w a~ .'1vei- er.►" rvo4'

Setbacks N/A J Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 4 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments r

Date: /__/ 2 S'/2002 Inspection Team: Name: . fs'teft Agency: 1~ Name: A. 01 /0 Agency: N

NYC-WTC 000122582