WTC inspection form for 180 Broadway

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100E(61 emise Address: Block: (p5 ResidentialD Commercial Name of Building: Lot: I 0 Mix Use Other # of Stories: AKA's: Building Owner/ anagement• Telephone Number: ( ) Name: FAX: Address: On Site Conpct: Name: * s Telephone Number: Building owner Management ctivities Interior Survey Performed fYes ❑ No Exterior Survey Perfo d '1es ❑ No General Clean Up BYes ❑ No Locations: ACM Clean Up ❑.-Yes ❑ No Locations: Air Monitoring B] Yes ❑ No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" Facade Description:

Roof p)sti Debris: '1No Visible /Fine Layer ❑ % to 1" .1 ❑ > 1" ' Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑'/ 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 ❑ Ya to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: L1IS/2002 Inspection Team: Name: u -Agency: -r Name: _ Agency: V NYC-WTC 000122838