NYC 9/11 Public Portal Document
WTC Visual Survey Form
Premise Address:
81. GCE' 4 ' CH £'ra a e7r
Block: Residential D Commercial 0 Name of Building:
Lot: Mix Use ❑ Other ❑
# of Stories: AKA's: L/L 11th i-f ~-
Building Owner/Management: Telephone Number: (212) q73_ ,3
Name: t t3& LLG FAX:
Address: u.c
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 Kesuits:
Facade:
Inspected Debris
North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/2to1" 0>1"
South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/2to 1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" D>1"
West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/2tol" ❑>1"
Facade Description:
1g w t.1 I4& Rt S
Roof sti
Debris: ❑ No Visible /Fine ayer ❑ /2 to 1" ,1 =~'"' ❑ > 1" 1
Description: i1a g - o Time (mot= ti Aga co AC 7 i t Fo,
C.e;Cam Myzsc— .,4c ( _ 2.i - Air 2 1 Z 'Jv.
Setbacks N/A ❑
Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer 0V to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1"
Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"
Comments
!4
Date: 002 Inspection Team: Name: C. Lu-rcNmED tAL Agency: N4CDe?
ENS Name: Agency:
NYC-WTC 000128355
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