WTC debris inspection form for 195 Broadway, n.d.

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: — —

Block: Residential 0 Commercial Name of Building: Lot: 0j Mix Use 0 Other # of Stories: AKA's: _ h ,z cW ~r N ,, Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: 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 9Yes ❑ No H-Nr ie/Fine Layer ❑ Y 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 ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Facade Description: t=: i t:rle )t : ~., . ,/&. r r

Roof

Debris: ❑ No Visible /Fine Layer ❑ Y2 to 1" ❑ > 1" Description: ' t t= i •7 i?mot...- nn ,,rt-~y~' < <,~,~, y~;,~ ~ •f- J. r,

Setbacks N/A Floor. 9 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 ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

te: J / U U /2002 Inspection Team: Name: !Z 'F i F~, PJ..l-ri c t, Agency: USCPP Name: R ticim rrwh Agency: N yc DEP

NYC-WTC 000123124