WTC facade inspection form, 196 Broadway, Feb 2002

NYC 9/11 Public Portal Document

tod~2l~ WTC Visual Survey Form Premise Address: 1 I — I? ~ -fro ad ~ a IN G Block: Residential 0 Commercial JJ N'ame of Building: Lot: I Mix Use Other # of Stories: AKA's: 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 p Yes

visual inspection Results: Facade: Inspected bris North ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑vtol" 0>1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ atol" 0>1" East ❑ N/A ❑ Yes ❑ No EU No Visible/Fine Layer ❑%to1" 0>1" West ❑ N/A ❑ Yes ❑ No El]No Visible/Fine Layer ❑Yto1" 0>1" Facade Description:

Roof

Debris: No Visible /Fine Layer ❑ % to 1" 0>1" Description:

Setbacks N/ALL Floor 1 Debris: ❑ No Visible/Fine Layer 0 1/2 101 ❑ > 1" Floor. Debris: Q No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor. Debris: j] No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor Debris: Q No Visible/Fine Layer L]'/2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: o`? //2002 Inspection by: Name: Al' Agency:, , P Name: Agency:

NYC-WTC 000123162