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2 ity wea «OTHER whe Oe — Washington Civil Disorder Survey Tracking Form Survey File Ho. g Z PR = Survey Staff Person with LF Basiness on [TJ Property Primary Responsibility. SR = Survey Staff Person with fear Responsibility. ck. By Date " Efd 0 Hope RgoGn FG te. k PR 3. Further Identification and Call-Backs: A. Started PR B, Questionneire Re-mAling Request Made to CONTROL PR C, Contact Notes: FR PR PR = > Continued Over. PR Patel a peel en ato 4, Questionnaire Received ORET=Bilied-Out-¥y-PR, Reported to CONTROL 5e Questionnaire Examined: ‘Identification Checked; If Incorrect, Reported to CONTROL CT No Damage or Loss; File Returned to CONTROL & Terminated PF ms or Loss; Reported to CONTROL for Agency Inf. Form oR ee E Questionneire Complete; No Call-Backs Needed ™ [J Guostionnaire Incomplete; Call-Backs Needed 6, CallePaeks: A. Started B. Contact Notes:, ne > Continued Over. ~ c. Cai sai jationna’ % tions of Other Affected Businesses or Properties Found: No on [J Yes, Reported to CONTROL Perea Alcaroie 2 9. Questionnaire Received for C&AC CAAC Completed; Questionnaire Returned to PR 10, Questionnaire Received Additonel Work, If Any, and Questionnaire Completed 11, Agency Information Form Completed: Location Information Recorded DUC BD Information Recorded 80C, SEC, Information Recorded “I2. EDP Coding Shoot Completed 13, Entire File Referred 10: SR for C&AC SHESSS 3 38 88 rer C&AC U4, Entire File Received for C&Ac C&AC Completed; Entire File Returned to PR 3 $8 3 8 sss 15. Entire File Received ‘Additional Work, If Any, and File Certified Completed and Forewarded to CONTROL 3 16, Entire File Received; Entry Made on Control Sheets Control, EDP Coding Sheet Forevarded for EDP Control, ~ All Other Materials Filed Control, File PR: 1. [J Tracking Fora; 2. [J Yaestionnaire; Agency Information Form; and 4. [7] EDP Coding Sheet. District of Columbia Civil Disturbance Report Business Information Survey “a9, > Please complete one of these forms for each business establishment you are associated with that sustained any physical damage or theft, however minor, during the recent civil disturtance in the District of Columbia. If an establishment you are associated with sustained no physical damage or the! all, please complete Itens 1,2, and 3 only and return the form. A business Satablishuent is defined as any comercial enterprise or unit at ono address. If you need more forms, please call Miss Geraldine Johnson, D.C. Redevelopment Land Agency, telephone: 382-6950. Business Establishment: 1. Nemes__BvLe's Launoky ANd Dey Cecnnialg (PH Addresss, 1g LEH LM pe. 3. Phones_/72 2-771/ 1,/Dple Firet Danage or Teft Oscurreds__ Alper. td $y/oete)sogunt Danages or Rates Omerve, 1 art Blip ae ls (Business Omer (or Principal Officer): 6. Names__ S#AW Foe CHIN [7 Ager £7 ndor 30; £7 30 to 50; LT over 50. e.feace: [7 whites [7 Nogros L7 other. Home Address: $007 Albemavée Street, MW. Phone:_ 342-577 Mahager of Botablishnent (If Different from Omer): 10, Names Ll. Ages £7 Under 30; (7 30 to 503; 7 over 50. a2. Races £7 whites [J Wogros [J other. 13s Home Address? Phone:, 1k: Date ZatanListnent, Yao Located at ng iv OR An Taig mediate Neighborhood: ‘After 1965; [7/1960 to 19655 1950 to 1959; £7 1940 to 194: Before 19L0+ 1sCOmepship of Business: {7 Single Proprietorship; 7 Partnership; [7 Corporation; Other = Specify: 16. ‘Type of Zstablishment Operations (Check All L 2 Appropriate Boxes): Wore Than 50 Percent’ Leas Than 50 Percent of Dollar Value of _of Dollar Value of Sales Sales A. Manufacturing B. Wholesale Trade C. Retail Trade -D. Service E. Warehousing Fy Other ~ Specify, sy + Tay Cleaners Af. Specify Principal Product or Services pay py Classe Seppe concn menor es a Geis preteen eee ire delta prenissa wbee Reaeas kev ecaatreah es ERLE 19. Total Annual Rent: §. Be ae ee ee rem ree Bt Retsha heot bor Sgiare Foot 22, If the premises were rented for this establishment, has there been any change up to now in the rental status of the establishment as a result of the civil disturbance: No Change Business or Establishment Sold Lease Terminated Rent Increased and istablishment Still in Business Rent Decreased and Establishment Still in Business Establishment is Out of Business, But Continuing to Pay Same Rent Establishment is Out of Business, But Paying Lower Rent Other ~ Specify: «Approximate Gross Sales of This Establishment During Last Tax Year: $_/57¢&¥ gO 2k. Approximate Taxable Incone from This Establishment During Last Tax Year: §__ 4, 242.47 25. Trade Area of This Establishnent Before Civil Disturbance (Check All Appropriate Boxes): Primary Market Secondary Market (s Wore Than $0 Percent Less Than 50 Percent ‘of Total Dollar ‘of Total Dollar whe y Value of Sales Value of Sales Wo Conwnmer Consumer Wholesale Consumer Wholesale ease see OS ee aa Ge As Immediate Neighborhood (Within 10 Blocks) B, Larger Section of District of Columbia C. All of District of Columbia a D. Parts or All of Washington Metropolitan Area B. Larger Region Including Wash. Metrop. Area Approximate Nunber of Square Feet of Floor Space Now Occupied ty This Establishments £20 fe ay Riploynont of RstabLishnent During Full Work Week Before Civi2 Disturbance: Thumber of Persons Wo empleyee) only White —_egro____Other “Total Me hae Res me toes le fem Cnnice + wire) Ge ee ee ee A. Paid and Unpaid Family Workers (Including Owner) mee Of Of B. Part-time Paid Employees (Less | ‘Than 10 Hours) ee nial cee ee) ag Dar Full-time me Employees (40 Hours or More): ft. Mamgerial & Professiol BE ME pf be Clerical mb im alan cla — — —— es Sales — o.oo Se oe 2: Craftenen & Other Skited = ae : Drivere & Other Seni-silied oo oe £1 Laborers & Other Unekilled a ae i . Pulantine suttotan (GO) BH) (9 (_) 94) 9 De ESTABLISHMENT TOTAL of - (Ee fe ae 296 306 2 Employment of Establishment During Most Recent Full Work Week: Number of Pers: White Tegro Other Total No Empelyee Higle Female fale Fenale Vale Female Wale Female A. Paid and Unpaid Fanily Workers (Including Omer) meme (eae B. Part-time Paid Huployees (Less Than 40 Hours) C. Full-time Paid Buployees (40 Fours or More): 5 a, Nanagerial & Profesional bs Clerical 7 ce Sales 4. Craftsmen & Other Skilled e. Drivers & Osfier Semi-sicilled £2 Laborers Wother Unskilled G- Fulleineteubtotal (C2) (22) (2) (GEN) (04) ek) RS) (SS) :STABLISHMENT | How nary enpleyees0f this establishment were transferred to other locations of your business, |i?’anys as a result of damage from the civil disturbance? Qenz— _ persons How many emp¥oyees of this establishment, if any, did your firm help find Jobs with other businesses, ise of damage from the civil disturbance? _ —yyaue. persons Type of Dane or Loss (Check ALL Appropriate Boxes): __(1) 2) Tinited Bitensive As Breakage of Glass B. Theft of Merchandise C. Smoke Damage D. Water Damage E. Fire Damage ix LIGHT SipHS F. Other ~ Specify: A£¢turny 9 Dey clea Ellie chong = Present Condition of Premises: 7 Denolished; /Uo Repairs Undertakens Repairs Underway; /// Repairs Completed. Preserit Status of Business: {7 Closed; /7 In Partial Operation; Wa Full Operation; o C7 Noved Business or Establishnent Operations to Another tocation. If the business or establishnent operations were moved to another location, please indicate wiere? {7 In the Sane Neighborhood; // Elseuhere in Dale; 77 Outside Dec, Extent of Financial Loss (Please istimate, If Necessary): L 2) eae oe jock or Inventory Fixtures & fauinment © Total A. Value Prior to Civil Disturbance = ge _——_ toes Be Value of e or Loss from = af Civil Disterance gos 7000.00 +__Lopand C. Amount of Insurance Coverage ———a) g 2.00 & 2.00 D. Insurance Compensation Received Up to. Now see) 4__ 0.00 s__ated 38. 396 10. Hag the inourance on this establishyéit been changed since the civil gisturtance? ‘LT cancelisas [7 Reduced; /°7 Other ~ Specity: Futurg Plans (Even Though Plans May Be Tentative): ell Business or Establishment Renain Open for Business at. Sane Location Reopen for Business at Sane Location Relocate Business or TstabLishnent Elsewhere in Sane Neighborhood Relocate Business or BstabLishnent Outside of Former Nesghborhood, But Inside D.C. Relocate Business or Dstablishnent Outside of D.C. Sinpiy Co Out of Business Other ~ Specify: iat reasons are the most important, in selecting one of the above alternatives over the others for you, your business or eatablisimen$? (Please, oxplain and yse the reverse side ofthis page, if needed.) : ; Toneck the appropriate box telow if you wish inforeation about any of the folowing: Snall Business Administration programs sistance in finding a new location flatraining or employment assistance | 2G cther avetstance, such ae legal or accounting ~ Spectf ZO ‘ OGRA. ‘mnie form was completed by - Signatures EE pater_f 12+ 1760, nities (Owserr ~ Do Not Write Below This Line il