WTC visual survey form, 106 Duane Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form I OO I£ `Premise Address:

Block: 1 Q Residential Commercial J Name of Building: Lot: Mix Use Otherfl # of Stones: 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 ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No No Visible r ED% to 1" 0>1" South ❑ N/A Yes ❑ No No Visible r ❑%to1" 0>1" East ❑ N/A ❑ Yes ❑ No No & Visible/F ❑'/tol" ❑>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%tol" 0>1" Facade Description:

Roof

Debris: Callo Visible l t- yec, 0'/: to 1" 0>1" Description:

Setbacks N/A [ Floor: Debris: ❑ No Visible/Fine Layer ❑ h to 1" ❑ >V Floor: Debris: ❑ No Visible/Fine Layer ❑ %: to 1" ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer 0 %% to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" [3> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'% to V ❑ > 1"

Comments

Date: / /3 12002 Inspection Team: Name: f r ` rt> Agency: 7) &:-i>. Name: Agency:

NYC-WTC 000126198