WTC building inspection form, 199 Chambers Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form ►,remise Address: r ~~~fi f~r~ l ._. 5 Block: Resi ntial Commercial Name o Building: Lot: Mix Use D Other # of Stories: AKA's: Building Ow er/Mana a ent: Telephone Number: ( ) Name: U /V FAX: ( L Address: On Site C n ct: Name: kd Telephone Number: (1.1?.) >-2o - S v ~-- Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up J Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested 0 Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Facade Description: ^ -, L F " Ct

Roof

Debris: ❑ No Visible /Fine Layer ❑'/ to 1" ❑> " Description: 9.L -'fir dç xiLJ-

Setbacksks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑>1 Floor: Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments r --

/2002 Inspection Team: Name: s Agency: Np—s Agency:

NYC-WTC 000126994