WTC facade inspection form, 180 Duane Street, undated

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: I g Block: Residential S Commercialfl Name of Building: Lot: Mix Use J Other # of Stories: AKA's: Building OwneNManagement: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: " ' .. ojut 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 fl Yes

visual inspection Results: Facade: Inspected Debris North ,N/A ❑ Yes 0 No ❑ No Visible/Fine Layer ❑ Ya to 1" ❑ > 1" South ❑ N/A es ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1' East ® N/A tj Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West [Z N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Facade Description:

Roof

Debris: ( &o Visible /Fine Layer .❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 1/2 to? ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Ya to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 0 % to 1" ❑ > 1"

Comments

Date: $ / I 11002 Inspection Team: Name: Cltst Agency: Name: Agency:

NYC-WTC 000130693