WTC site inspection form, 176 Duane Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: i

Block: ResidentialD Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management: Telephone Number ( ) Name: FAX: Address: On Site Contact: Name: Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed ❑ Yes No General Clean Up ❑ Yes 0 No Locations: ACM Clean Up ❑ Yes [] No Locations: Air Monitoring ❑ Yes [] No Locations: Copies of All Report. and Data RequestedD Yes

Visual lnsDection Results: Facade: Inspected Debris North s -N/A ❑ Yes ❑ No O No Visible/Fine Layer ❑ 6 to l" 0>1" South 0 N/A ..SYes ❑ No o Visible/Fine Layer ❑%to1" 0>1" East N/A D Yes Q No No O Visible/Fine Layer %to1" ❑>1" West N/A 0 Yes ❑ No ❑ No Visible/Fine Layer ❑ % to l" 0>1" Facade Description:

Roof Debris: l Jo Visible /Fine Layer L] to l" 9>1" Description: /

Setbacks N/AL] Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" 0>1" Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑'h to 1" 0>1" Debris: 0 No Visible/Fine Layer Floor. Floor % to 1" Debris:F No Visible/Fine Layer F] 34 to 1" B > 1" 30 1 "

Comments

Date: )I 1 /2002 Inspection Team: Name: C Agency: ENTERED Name: Agency:

NYC-WTC 000127496