Building inspection questionnaire, 181 Broadway, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: Q

Block: Residential Commercial D Name of Building: Lot: I Mix Use g] Other ❑ # of Stories: AKA's: Building Owner Management: Telephone Number. (Li ) 7Ts - 7or; Name: C ,^ env FAX: (tiz) 7z - Address: !/e.1 5 /. si. `t/.. ovo On Site Contact: Name: ' " ,etcAsrW 4e// Telephone Number: (1-,2 ) 72-7ç-3 Building Owner Management Activities" Interior Survey Performed ❑ Yes ❑ No ? Exterior Survey Performed ❑ Yes ❑ No General Clean Up ® Yes ❑ No Locations: Ge wwr ñCc'sr tr y (tilt (c . 'r ACM Clean Up ❑ Yes ❑ No? Locations: Air Monitoring ❑ Yes ❑ No , Locations: Copies of All Reports and Data Requested D Yes

Visual Inspection Results: Facade: Inspected Debris North ® N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ to 1" '/2

South ® N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ to 1" 1/ 2

East J N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" West ❑ N/A ® Yes ❑ No No Visible/Fine Layer ❑ Y2 to 1" Facade Description:

Roof S ;

Debris: ❑ No Visible /Fine ayer ®'/2 to 1" ❑ > 1" Description: Pe/,,+s rte, &r•

Setbacks N/A 0 Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" ❑ > 1"

Date: /_/c/2002 Inspection Team: Name: _

Agency: Name: t Agency: N

NYC-WTC 000122942