NYC 9/11 Public Portal Document
WTC Visual Survey Form
PE etn d Address:
CUR 14 > 'r'c-( fj G(
Block: Residential 0 Commercial Name of Building:
Lot: Mix Use Other 7 1/ 1 r fe (
# of Stories: 56 AKA's: <J °
Building Owner/Management: elephone Number: ( )
Name: L o. - Ot~rvcr• FAX:
Address:
On Site Contact:
Name: Jr -(.'v' /'M - $-ee,..;i Tele hone Number: ) NowC
Building Owner Management Activities
Interior Survey Performed ® Yes ❑ No
Exterior Survey Performed ® Yes ❑ No
General Clean Up ❑ Yes ❑ No 2 Locations:
ACM Clean Up ❑ Yes ❑ No . Locations:
Air Monitoring Yes ❑ No Locations:
Copies of All Reports and Data Requested J Yes
visual inspection Kesuits:
Facade:
Inspected Debris
North ❑ N/A Yes ❑ No No e/Fine Y2 to 1" ❑ > I"
South ❑ N/A Yes ❑ No No Visi '/2 to 1" ❑ > 1"
East ❑ N/A (~ Yes ❑ No LJ No Visi Y2 to 1" ❑ > 1"
West ❑ N/A Yes ❑ No © No VisiWLa
Visi Y2 to 1" ❑ > 1"
Facade Description: /
pin L.:.. l.,.r 'L w~ e(t -/
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re
Roof
Debris: No Visible /Fine..ayer ❑ Y2 to 1" 1 , " ❑ > 1" 1 t ~
Description:
Setbacks N/A
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 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 0'/2 to 1" ❑ > 1"
Comments
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Date: I / /2002 Inspection Team: Name: A. F' 1 /1 a ^-2/1c Agency:
Name: fl Agency: &IYc PEP
NYC-WTC 000126216
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