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Document / 4 pages

WTC debris inspection form for unknown building, 2002

Machine-extracted title · confidence 80%

Inspection form documenting the assessment of World Trade Center debris on building exteriors including facade and air monitoring checks.

NYC-WTC_000126241–000126244

Folder label: “5 DEY STREET 1001071, 63/12”

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Scanned page image, NYC-WTC_000126241
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OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ,_.

Block: 6 Residential 9 Commercial Name of Building: Lot: t )— Mix Use O Other # of Stories: AKA's: S — 7 Buildin Owner/Management Telephone Number: ( ) Name: Q- s I l L FAX: Address: S On Site Contact: Li 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 O Yes ❑ No Locations: Copies of All Reports and Data Requested D Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ h to 1" O>1" South ❑ N/A DYesDNo ❑ No Visible/Fine Layer ❑ h to l" O>1' East ❑ N/A DYesDNo No Visible/Fine Layer ❑ 34 to 1" O>1' West ❑ N/A ❑ Yes ❑ No HNoVisible/Fine Layer ❑ 1A to 1" O>1' Facade Description:

Debris: ❑ No /Fine Layer _ ~p 1"' ❑ > Description: ____,

Setbacks N/A ❑ Floor. Debris: O No Visible/Fine Layer O Ys to 1' ❑ > 1' Floor. Debris: No Visible/Fine Layer ❑ '4 to 1' ❑ > 1" Floor: Debris: No Visible/Fine Layer [] i4 to 1" ❑ > 1" Floor. Debris: No Visible/Fine Layer % to 1" ❑ > 1" Floor. Debris: No Visible/Fine Layer V4 to 1' O> 1" Comments

Date: ~L / 12002 Inspection Team: Name: Agency: T Name: Agency: E B

NYC-WTC 000126241

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NYC-WTC_000126241Source: NYC Law Department, mirrored locally

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