WTC debris inspection form, 189 Broadway, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premihe-Address: 21 Block: Residential 0 Commercial J Name of Building: Lot: Mix Use Other # of Stories: AKA's: tv i ';'~4u Building Owner/Management: Telephone umber: ( ) Name: FAX: ) Address: On Site Contact: r,14---'1 ø"a• - Name: Telephone Number: ) Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: 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 ❑Y2 to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0%to1" 0>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ❑ % to 1" ❑ > 1" Description: v s f bk ,: ~ChN7 s ~ku r +~ ~l ~ f"t - ts+, 'S

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

Comments

Date: f_/ . ( /2002 Inspection Team: Name: _i ; +~r~~~ +~ Agency: ('R Name: l2. IAA ni' - ' i -4 Agency: M.7 ~ RCLtN NYC-WTC 000123055