WTC environmental inspection form, 177 Broadway, undated

NYC 9/11 Public Portal Document

WTC Visual Survey Eorm Premi .~.j

Block Res[dential 0 Com er ' Na a of Building: Lot: Mix Use 1 J Other Y I # of S o es: 6 AKA's: Building Owner/Management: Telephone Number. (tz. ) a-- - Name: FAX: Address: On Site Contac Name: - • .j4 -Sol✓ /4v1/,4 <ryvr.4 Y/ p. Telephone Number (Zt L) Building Owner Management Activities interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up J Yes ❑ No Locations: ,-+Rbr . l04 ACM Clean Up ❑ Yesj No Locations: Air Monitoring BYes U No Locations: Co ies'of All Reports and Data Requested Yes Visual inspection Results: facade: Inspected Debris _North ❑ N/A ® Yes ❑ No ❑ No Visible/Fine Layer 34 to 1" 0>1" South ❑ N/A ® Yes ❑ No ❑ No Visible/Fine Layer 'h to I" 0> 1" East [] N/A Yes ❑ No ❑ No Visible/Fine Layer % to 1" ❑>1" West 0 N/A IJ Yes ❑ No ❑ No Visible/Fine Layer J % to 1" ❑>1" Farnrio rloee+rintinn-

Roof

Debris: QNo Visible /Fine ayer 5a Y2 to 1" •9 ' ❑ > 1" 1 Description: i- on, fir ms's e•i' a t / 6i ld•)w t'•

Setbacks N/A ❑ Floor f 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 036 to 1" ❑.> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Date: I/ i /2002 inspection Team: Name: P. P12 1HCi' Agency: 6P4 Name: , O1 //O Agency: NK C D F

NYC-WTC 000122759