DOT building operation permit, August 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: /2-1 & rX Block: ResidentialD Commercial O Name of Building: Lot: Mix Use Other ❑ # of Stories: AKA's: Building OwnerlManagement Telephone 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 ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

visual inspection Kesuits: Facade: Inspected Debris North 0 N/A L Yes ❑ No ❑ No Visible/Fine Layer ❑ V2 to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1" Facade Description: 1): t' i . J-t nr•=, y ter I K'c

Roof

Debris: Q No Visible /Fine Laypr ❑ Viz to 1" 0>1" Description: L : t) 1 \ 1 +3

Setbacks N/A 0 Floor: Debris: ❑ No Visible/Fine Layer ❑ %2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %2 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"

Comments

Date: `= / /2002 Inspection Team: Name: At Agency: Name: IicitfZ: Agency:

NYC-WTC 000127393