WTC Visual Survey Form 10013+~A
Prrrnise Address:
Block: Residential 0 Commercial Name of Building:
Lot: Mix UseD Other
# of Stories: AKA's:
Building Owner/Management Telephone Number. ( )
Name: o, c. €i f • FAX:
Address:
On Site Contact:
Name: ' ' Telephone Number.
Building Owner Management Activities
Interior Survey Performed ❑ Yes Q No
Exterior Survey Performed (3 Yes j] 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 inscection Results:
Facade:
inspected De ris
North Er NMe Yes No No Visible/Fine Layer 0%to1' D>1'
South Q4Wr Yes No No Visible/Fine Layer ltol' >1'
East N/A Yes No No Visible/Fine Layer R
West N/A Yes 0 No No Visible/Fine Layer %tot' D>1'
Facade Description:
Debris: D No Visible /Fine Layer .934 to 1'
Description:
Setbacks N/AD
Floor.___ Debris: No Visible/Fine Layer j] 36th 1' ii'
Floor____ Debris: No Visible/Fine Layer Q % to 1' > 1'
Floor._ Debris: No Visible/Fine Layer 34th 1' > 1'
Floor____ Debris: No Visible/Fine Layer % to 1' >1'
Floor___ Debris: No Visible/Fine Layer 36 to 1' > 1'
Comments
NYC-WTC 000129123
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000129123Source: NYC Law Department, mirrored locally