Label sheet, 39 Broadway, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premiss Address ti:.c\A) Block: I Residential j Comrnrial J f Name of Building: Lot: Mix Use J Other # of Stories: AKA's: Building Owpr4Ma e nt: Telephone Number: (~ -z) Name: e s~ FAX: Address: On Site Contact; , K ~~ Name: ~~ Telephone Number: Building Owner Management Activities Interior Survey Performed des ❑ No Exterior Survey Performed EYes ❑ No General Clean Up. Yes ❑ No ACM Clean Up ❑ Yes Locations: o Locations: 1L j~ 1~'L.4/t"\

Air Monitoring [tes 0 No Locations: Copies of All Re orts and Data Re uested es

Visual Inspection Results: Facade: ~,i 'o \1'c-t` "' A-2c Inspected Debris . No Visible/Fine Layer ❑ % to 1" ❑ > 1" South ~; N/A~ Yes ❑ No o Visible/Fine Layer ❑'/ to 1" > 1" East ~''/ N/AIDu es ❑ No o Visible/Fine Layer ❑ % to 1" Q > 1" West N/A! gYes ❑ No Visible/Fir Layer ❑ 2 to 1" ❑ > 1" Facade Description:

Roof

Debris: Description: o Visible /Fine aver ❑ Y. to 1" -1 ❑ > 1" 1

Setbacks N/ Floor: Debris: ❑ No Visible/Fine Layer ❑ /s to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: [] No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /s to 1" ❑ > 1"

Comments

Date: / /2002 Inspection Team: Name: ~'~ C t-h~► C-- ►'t Agency: Name: Agency:

NYC-WTC 000123597