WTC facade inspection form, 116 Duane Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form l oO f -IV Premise Address:

Block: Residential 0 Commercial 0 Name of Building: Lot: 1 Mix Use Q Other # of Stories: 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 0 Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested D Yes

Visual inspection Results: Facade: Inspected Debris North ❑N/A ®YesONo No Visible/ eryer /2to1w a >1w South ❑ N/A Yes ❑ No No Visible r ❑'/ to 1" 0>1" East ❑ N/A Id Yes (] No O No Visible/Fine Layer ~ iato1w w

West ❑N/A 0Yes0No O No Visible/Fine Layer ❑Y:to1" 0>1" Facade Description:

Roof Debris: 0 No Visible 0 1/2 to 1" 9> 1" Description:

Setbacks N/A 0 Floor. Debris: ❑ No Visible/Fine Layer j] % to 1" 0>1' Floor. Debris: 0 No Visible/Fine Layer [] 34 to 1" 0> 1" Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1" > 1' Floor. Debris: Q No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: [] No Visible/Fine Layer 0 % to V D > 1"

Comments

Date: 5/ /2002 Inspection Team: Name: !Ph7ll Agency: 6 Name: Agency: N T E R E

NYC-WTC 000126207