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← Document results/DEP Box 49/202 BROADWAY 1001221, 79/19
Document / 5 pages

WTC visual inspection form, 202 Broadway, 2002

Machine-extracted title · confidence 80%

Form recording a WTC visual inspection at 202 Broadway with contractor details and sample numbers.

NYC-WTC_000123247–000123251

Folder label: “202 BROADWAY 1001221, 79/19”

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Scanned page image, NYC-WTC_000123247
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NYC 9/11 Public Portal Document

WTC Visual Survey Form Bm*100IZZA Premise Address: r~0 a -Bro a d w

Block: 71 Residential U Commercial J Name of Building: Lot: l9 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 [j 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 l" [J>1" South ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer % to 1" E]> 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer % to l" [J>1" Facade Descriptisn4~~ Ui~

Roof

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

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ %z to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1"

Comments

Date: / 1512002 Inspection by: Name: AP Agency: D( P Name: Agency:

NYC-WTC 000123247

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NYC-WTC_000123247Source: NYC Law Department, mirrored locally

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