WTC debris inspection form for unknown building, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form "` 'A-i Premise Address: _ -i ,r S`i Block: Residential O Commercial Name of Building: Lot: Mix Use Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name:M i c N4E"~ / r FAX: ( ) Address: On Site Contact: S u par~ -------------------------------------------------------- Name: r' iz S A ,r Telephone Number P11 Building Owner Management Activities L.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-. Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up Yes fl No Locations: _N ;! n E K ; ACM Clean Up JJ Yes J No Locations: Air Monitoring es ❑ No Loca_ _tions: , . -Oz eE N ; i s. c A r i S II Copies of All Reports and Data Requested Yes P visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/2tol" ❑>1" South N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/2 to 1" O>1" East N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/2 to 1" O>1" West [4 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" O>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer ❑'/2 to 1" ❑ > 1" , T1 Description: v, e ')c. r~ , 1 c ,= :1 II i L (=t ►v

Setbacks N/A 2 Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ /: to 1" ❑ > 1" Comments

Date: ) 1.2. G /2002 Inspection Team: Name: R' Fri r4 .I r i c;. Agency: U sc ell Name: i: u,a.v Agency: , ? RF 9A NYC-WTC 000126242