WTC Visual Survey Form Mal I R''7
Premise Address:
44Gro4 ST
Block: Residential 0 Commercial fJ Name of Building:
Lot: 25 Mix Use J Other ❑ ? Cvz4i C4
-
# of Stories: AKA's:
Building Owner/Management: Telephone Number:
Name: FAX: Z -i g -r
Address: LJ.4 & j, cc.
On Site Contact:
Name: A 'sue- 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 ❑%to 1" 0>1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1"
West ❑ N/A .®Yes ❑ No 2 No Visible/Fine Layer ❑%to 1" 0>1"
Facade Description:
Roof
Debris: ,/z to 1" 0>1"
Description:
Setbacks N/A0
Floor. Debris: ❑ No Visible/Fine Layer 0 Y to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Comments
-amw*
,ter
Date: Z / / S' /2002 Inspection Team: Name: rl Agency: P.
Name: Agency:
NYC-WTC 000128138
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000128138Source: NYC Law Department, mirrored locally
WTC debris inspection form documenting visual inspection results for facade condition, ACM assessment, and building characteristics for a 3-story structure.