WTC site inspection form, 178 Duane Street, 2002

NYC 9111 Public Portal Document

WTC Visual Survey Form remise Address:

Block: Residential Commercial p Y Name of Building: Lot: Mix Use 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 No Exterior Survey Performed DYes g No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑34to1" 0>1" South ❑ N/A es 0 No .RNo Visible/Fine Layer ❑%to1" 0>1" East ❑ N/A Dyes D No ❑ No Visible/Fine Layer ❑ % to l" 0>1" West ❑ N/A []Yes ❑ No O No Visible/Fine Layer ❑%to1" 0>1" Facade Description:

Roof Debris: P.No .No Visible /Fine Layer .0 % to 1" ❑ > 1" Description:

Setbacks N/A[] Floor Debris: 0 No Visible/Fine Layer ❑ Y: to 1" >1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 4 to 1" >1" Floor. Floor Floor Debris: ❑ No Visible/Fine Layer 034101" Debris: n No Visible/Fine Layer Debris: 0 N Visible/Fine Layer 86 h to 1" to 1" 0>1" >1" H.** 1" Comments

Date: S l l 12002 Inspection Team: Name: ~ Agency: ENTERED Name: Agency:

.~ NYC-WTC 000127500 _