NYC 9/11 Public Portal Document
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WTC Visual Su Form
Premise Adc teas: lS (
Block:
Lot: Mix Use Other
# of Stories: AKA's:
Building Ow nagement:
FAX:
Name:
On Site Contact: Telephone Number:
Name:
Building Owner Management Activities
Interior Survey Performed ❑ Yes 0 No
Exterior Survey Performed ❑ Yes 0 No
General Clean Up ❑ Yes 0 No Locations:
ACM Clean Up 0 Yes 0 No Locations:
Air Monitoring 0 Yes 0 No Locations:
Cooies of All Reports and Data Requested 0 Yes
Visual Inspection Results:
Facade:
Inspected Debris
North 0 N/A 0 Yes U No ❑ No Visible/Fine ay ' j 2
0 No Visible/Fine Layer E /2 to 1" ❑ > 1"
South 0 N/A 0 Yes 0 No 0>1"
0 No Visible/Fine Layer 0 114t0 1"
East ❑ N/A ❑ Yes 0 No 0>1"
0 No Visible/Fine Layer 0'/2 to 1"
West ❑ N/A ❑ Yes 0 No
Facade Description: hg= CSLr~i
.i1 v ~ `~'~wt'' ~c,3 S
Roof
No Visible /Fine Layer ❑'/2 to 1" El> 1"
Debris: r =i C v}- 5 C
Description: f ►.s C , it- i ( w-r
Setbacks N/A 0 ❑ > 1"
Floor: Debris: 0 No Visible/Fine Layer 0 '/2 to 1"
Debris: 0 No Visible/Fine Layer 0'/2 to 1" ❑ > 1„
Floor: 0> 1"
Floor: Debris: 0 No Visible/Fine Layer 0'/2 to 1"
Floor: Debris: 0 No Visible/Fine Layer 0 1/ a to 1" 0> 1
Debris: 0 No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1"
Floor:
Comments
D
0 ►` / 12002 inspection Team: Name: H1 hgenuy.
Date: Name: M Ct.jI2L.LtC Agency:
NYC-WTC 000127114
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