WTC inspection form, 40 Gold Street, Mar 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100111 1 Premise Address: 40 A4O L-D 21 Block: T Residential tJ Commercial J Name of Building: Lot: 29 Mix Use D 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 ❑ 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: Inspected Debris North N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y to 1" 0>1" South N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" East ®'N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A [ Yes ❑ No ❑ > 1" Facade Description:

Roof

Debris: No Visible ❑Y2to1" 0>1" Description: Iw

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

Comments

Date: 02 Inspection Team: Name: Agency: I- 2/7_0,b1 Name: Agency: a.ec

NYC-WTC 000128112