WTC facade inspection form, 15 Dutch Street, Oct 2001

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1®0 tt T Premise Address: 15 D OTC N ST2 T Block: Tg Residential JJ CommercialD Name of Building: Lot: -r5c Mix Use Other # 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 ❑ 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 ❑Y2to 1" 0>1" South N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yato1" 0>1" East 0 N/A Yes ❑ NoN ❑ No Visible/Fine Layer /atol" 0>1" West ❑ N/A PYes ❑ No Q No Visible/Fine Layer , Vato 1" 0>1" Facade Description: 3 -s S D\1 o f 'Low ix il t 1 W i P1 po C2l LEDe e - Roof

Debris: ❑ No Visible /Fine Layer X%to1"` 0>1" Description: 13OL1c 6-t h R Fs i ,i5f A- I )€3( ( S /kso Ly r BOAT of DEPt24S 31 ELO .) I ABC tj IT

Setbacks N/A ❑ 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 ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑V2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1"

Comments

Nate: 06 / Os /2002 Inspection Team: Name: TDA Agency: D- P z

Name: Agency: W

NYC-WTC 000130830