WTC environmental inspection form, Museum of [name], undated

NYC 9/11 Public Portal Document

WTC Visual Survey Form IO9 y~7y Premise Address: g- L . : Residential D Commercial J Name of Building: Lot: f® Mix UseD Other - M9 - t. e.i ® r S 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 D No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Ej Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ 34 to 1' E] 1' South ❑ N/A Yes ❑ No No Visible/Fine Layer ❑ 34 to 1' 0>1. East ❑ N/A D Yes ❑ No BNoVisiblefFine Layer ❑ 34 to 1 0>? West ❑ N/A ❑ s ❑ No ❑ No Visible/Fine Layer ❑ 4 to 1' ❑ > 1' Facade Description: /I F n A

Roof

Debris: Visible !Fine Layer .934 to V ❑ > 1' Description:

Setbacks N/A Floor Debris: No Visible/Fine Layer % to V ❑ >V Floor____ Debris: No Visible/Fine Layer 34 to 1' 9>1w Floor Debris: No Visible/Fine Layer 34 to 1' 0>1 Floor Debris: No Visible/Fine Layer ❑ 34 to 1' [] > 1' Floor.____ Debris: No Visible/Fine Layer ❑ 34 to 1' [] >1

Comments 4J L--' CZA

Date: l ) (R002 , , Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000130639