WTC visual inspection form, 204 Broadway, 2002

NYC 9/11 Public Portal Document WI I v ..YaI VIII VW7 IF V/ III

Premise Address: 204 e- oAowAY 'S Block: Residential 0 Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: 2 AKA's: Building Owner/Management Telephone Number. ( I2. ) X3:3_ i96o Name: cou. i&rE actt FAX: Address: 45 SC>W W S -t - utw .40 uc iv Y l oo z $ On Site Contact Name: ' * -DAvtr> s2lvtAp.IZ Telephone Number. ( Ia 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 Q Yes

visual inspection Results: Facade: Inspected Debris North ❑ N/A ® Yes ❑ No l No Visible/Fine Layer South East ❑ N/A 0 N/A BYes ❑ No ❑ Yes ❑ No No Visible/Fine Layer " hto1" No Visible/Fine Layer ❑%to1" Q 0>1" 0>10 "

West ❑ N/A EYes ❑ No No Visible/Fine Layer ❑%to1" 0>1" Facade Description:

Roof Debris: ❑ No Visible /Fine Layer ®% to 1" ' " ❑ > 1" Description: wr.. vc-agis Cc NNACX rim aoo es UO I TS A*-1D Ok\ 1UEl e- tom. y3 Po r Pm pA S A'..s o ` gess Jr (K F

Setbacks N/A[ Floor Debris: ❑ No Visible/Fine Layer ❑ a to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ a to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 V to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ a to 1" E].'%. 1" Comments

Date: r ,~ 1002 Inspection Team: Name: _ 'P h / Ao 2.o Agency: RY c PEP Name: Agency:

NYC-WTC 000123279