Label sheet, 39 Broadway, Oct 2001

NYC 9/11 Public Portal Document

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WTC Visual Survey Form Premise Address {~

Block: Residential 0 Com er ial D Name of Building: Lot: Mix Use J J Other # of Stories: AKA's: TEA-'t'i G Building Ow r a ge nt: Telephone Number P11 Name: ~~ " O '1 \ ,--, ) FAX: Address: On Site Contacts , Name: Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed 2#es ❑ No Exterior Survey Performed Yes No ,(~ ~v v , General Clean Up. es ❑ No Locations: ACM Clean Up ❑ es o Locations: Air Monitoring [Yes No Locations: Copies of All Reports and Data Requested es

Visual Inspection Results: Facade: tJa Inspected tD ris o Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" South ,`~ N/ t, gals Yes ❑ No o Visible/Fine Layer ❑ %2 to 1" [3> 1" East Ces ❑ No Jo Visible/Fine Layer ❑ Y2 to 1" [3>? West N/A ( Yes ❑ No QAlo Visible/FirjR Layer ❑ Y to 1" ❑ > 1" Facade Description:

Roof ~. Debris: o Vsible /Fine ~ [3 % to 1" ,1 °L"" ❑ > 1" i"' Description:

Setbacks N/Q Floor: \ Debris: ❑ No Visible/Fine Layer ❑'/:to? ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1" 0>?

Comments

Inspection Team: Name: ( ol" !_%`tç( ^ C>r Agency: Date: I I2002 Name: Agency: ~ T E N ERE l7

NYC-WTC 000123598