Label sheet, 39 Broadway, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premisa Address (~

Block: Residential j Com er ial J Name of Building: Lot: Mix Use J Other # of Stories: AKA's: v-'\ G -------------------------------------------------, Building Ow r a g e nt: Telephone Number: PII Name: Q ~ ,~ c ~ ~.~ FAX; L-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.... Address: On Site Contac k , ~ K~ ~ Name: `~ Telephone Number: Building Owner Management Activities Interior Survey Performed des ❑ No Exterior Survey Performed EYes ❑ No General Clean Up ., Yes ❑ No Locations: 1~Y ACM Clean Up ❑ Yes Locations: Air Monitoring [es 0 No Locations: Copies of All Reports and Data Requested es

Visual Inspection Results: Facade: NJ )\1't'1.*"- 2c Inspected Debris No Visible/Fine Layer ❑ Va to 1" ❑ > 1" South ~; N/A Yes ❑ No o Visible/Fine Layer ❑'/ to 1" > 1" East ~ / N/A' uT es'❑ i No o Visible/Fine Layer ❑ % to 1" Q > 1" West N/Al [Yes ❑ No Visible/Fir Layer ❑ Va to 1" ❑ > 1" Facade Description:

Roof

Debris: • Visible /Fine aye A sti ❑ Y. to 1" •? ❑ > 1" 1 Description:

Setbacks N/ Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > I" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"

Comments

Date: 1//2002 Inspection Team: Name: t ' . Agency: ~- Name: Agency:

NYC-WTC 000123597