NYC 9/11 Public Portal Document
1 WTC Visual Su Form
Premise Address: ~t
Block: Residential 0 Commercial
Lot: Mix Use ❑ Other 't c c'L" C
-7 AKA's:
Name: CPv~~1'~c,t~i i'ti'>`i z- FAX:
Number: (-)1Z-) - G 6 1!76 6
i Name:
Interior Survey Performed ❑ Yes © No
Exterior Survey Performed ❑ Yes (t] No
General Clean Up ® Yes ❑ No Locations: N
ACM Clean Up ❑ Yes m No Locations:
Air Monitoring ❑ Yes [.j No Locations:
Conies of All Reports and Data Requested ❑ Yes
Visual Inspection Results:
Facade:
Inspected Debris
No Visible/Fine Layer ❑ Y2 to 1" 0>1"
North N/A ] Yes [] No 0>1"
South g N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1"
❑ No Visible/Fine Layer ❑ Y2 to 1" 0>1"
East ® N/A ❑ Yes ❑ No 0>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1"
Facade Description.. s
, Y1 1 -
Roof
Debris: [P'No Visible /Fine Layer ❑'/2 to 1" ❑ > 1"
Description:
Setbacks N/A [ ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1"
Floor. — Debris: 0No Visible/Fine Layer ❑ 16 to 1" ❑ > 1"
Debris: ❑ No Visible/Fine Layer ❑ 14 to 1" ❑> 1
Floor: ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1"
Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1"
Floor.
Comments
S ___
/2082 Inspection Team: Name: Agency:
Date: / !- C -t c. Agency: J2tit
~ "' Name:
NYC-WTC 000127423
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