WTC facade inspection form, 3 East Broadway, 2002

NYC 9/11 Public Portal Document q WTC Visual Survey Form 0o 3 93 cPiernaae Address:

Block:- 1-q ResidentiaI Commercial Name of Bui ing: Lot Mix UseD Other # of Stories: AKA's: Building Own r/Management Telephone Number ( ) Name: k t~si -. FAX: Address: - (O 3 -f 1 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 ❑%tol' 0>1' South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yato1' 0>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 0%to1' 0>1' West ❑ N/A j] Y~s ❑ No ❑_No Visible/Fine Layer ❑Y2to1' 0>1' Facade Description: ( ) in

Roof

Debris: t'i4o Visible /Fine Layer ❑%to 1' 0>1' Description:

Setbacks WA Floor Debris: ❑ No Visible/Fine Layer ❑'h to 1' 0>1' Floor. Debris: ❑ No Visible/Fine Layer ❑ h to 1' ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ % to V ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer 03410 1' ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' ❑ > 1'

Comments

Date: ../ / OE , Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000130843