WTC facade inspection form, 15 Cliff Street, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form 101 sq5 I Premise Address:

Bloc Residential Commercial I J Name of Building: Lot: Mix Use D Other 0 v # of S ories: 7 °2- AKA's: Building Owner/Management: Pok elephone 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 OYes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring laYes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A EYes ❑ ❑'No Visible/Fine--Layer ❑ 1/2 tol" ❑>1" 0>1 No

South ❑ N/A IN Yes ❑ No [ No Visible/Fine-Layer ❑Y2to 1" East ❑ N/A Yes ❑ No 'No Visible/F-me-Layer ❑Y2to 1" 0>1" West ❑ N/A ID Yes ❑ No QJ No Visible/Fine Layer ❑'/2 to 1" 0>1" Facade Description:

Roof

Debris: allo Visible /Fine-Layer ❑'/ to 1" ❑ > 1" Description:

Setbacks N/A Q. Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" 0>1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/2 to 1" 0>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"

Comments

Date: 2_I / c /2002 Inspection Team: Name: R AM~A1s+r✓ Agency: .CEP Name: Agency:

NYC-WTC 000126447