WTC debris inspection form, 183 Broadway, 2002

NYC 9/11 Public Portal Document I LJ-'` " ' / WTC Visual Survey Form remise Address: / 3 I3roa114/ Block: Residential D Commercial J Name of Buil ng: Lot: Mix Use Other ❑ /t3 f3,1, ,1d'c4rn # of Stories: y AKA's: .-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-. Building Owner/Management: Telephone Number:;.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.... P11 Name: I fIcLiIC' I * 11 diu.~~' FAX:( Address: On Site Contact: ------------------------------------------------------ Name: " ,1G /S i 1 A S Telephone Number:; P11 Building Owner Management Activities -.-.-.-_-.-.-.-.-.-.-.-. .-.-.-.-.-.-.-.-.-.-.-.-.-.-...- Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up M Yes ❑ No Locations: le0,0 ft A (1 fi,i,,,R (iv, e.4411 ACM Clean Up ❑ Yes ❑ No? Locations: Air Monitoring ❑ 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 ❑'/2 to 1" ❑ > 1" South ® N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ® N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A fZ Yes ❑ No No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description:

SM~II~irc Roof Sti 44 llsr

® No Visible to 1" .? ❑ > 1" 1 Debris: ❑V2

Description: 5,...i, R, ,. T O'-+

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ 1/ 2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments -ed ,ue, ,,-,-.I r v e if 1-u A- r cue ,. g -- r o •Q s f.•! /9,d ("ir 1l.e ,e r., ffc to x, 44

Date: / / ( /2002 Inspection Team: Name: Agency: Name: . oVe(lo Agency: NYC b E ?

NYC-WTC 000123005