WTC building inspection form, residential or commercial, Jun 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 123 F.J ro N S -ri2 r

Block: 91 Residential 0 CommercialD Name of Building: Lot: 9 Mix Use Other # of Stories: A AKA's: 46 A Siia i - Building Owner/Management cc-tAP. MG MT Telephone Number. (2-r. ) 732 -16 s3 Name: e I cu FAX: Address: 20 s -r Nq wY On Site Contact: BLt suer - Name: * .Q t.. Telephone Number. 9 ti 4 S i - oqi R 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 Results: Facade: In pected Debris North ❑ N/A ,Yes 0 N [] No Visible/Fine Layer % to 1" ❑ > 1"• South ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer J 4 to V ❑ > 1" East NIA Yes ❑ No ❑ No Visible/Fine Layer 34 to 1" [1> 1" West N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'h to 1" 0>1" Facade Des ription: B~WtS *Ot WiNbOLz) t CES Af. D R cESOAPe

I Roof ' Debris: ❑ No Visible /Fine Layer 6'/: to 1" 0> 1" - Description:

Setbacks N/AX Floor. Debris:[] No Visible/Fine Layer (]'h to 1" ❑> V Floor. Debris:[j No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 4 to 1" [1> 1" Floor. Debris:[] No Visible/Fine Layer ❑ h to 1" [] > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ 3 to 1" ❑ > 1"

I Comments

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Date: G / tt /2002 Inspection Team: Name: DA /AO 20 Agency: M'C Di' Name: Agency: f

NYC-WTC 000127866