WTC building inspection form, 100 Church Street, undated

NYC 9/11 Public Portal Document

`WTC Visual

Survey Form tool

44 O q Premise Address: 10o C INuRC 9•l Block: L2IIS ResidentialD Commercial Name of Building: Lot: Mix Use Other _.

# of Stories: AKA's: y Building OwerIMana a ent: Telephone Number. ( ) Name: FAX: • Address: On Site Contact: Name: bLdc4 tA4tW4( 0 • Telephone Number. Building Ownei21Aanament Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed 'Yes ❑ No General Clean Up gYes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑.No ❑ No Visible/Fine Layer []% to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" Facade Descript n:

•

Rdbf V Sut . r , Debris: ❑ No Visible /Fine Layer W'/ to 1" ❑ > 1" Description:

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

Date: 10 /_ /2002 Inspection by: Name: F T. Agency:t''I fC "P Name: PP, Agency:

NYC-WTC 000126784