44 JOHN STREET 1001110, 67/30

NYC 9/11 Public Portal Document

1

WTC Visual Survey Form 'Bt4*1001110 Premise Address: I 1I

Block: (0 7 t

Residential 0 Tc)hn Sfree+ Commercial Name of Building: Lot: 3o 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 ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1' South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" [3>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer h to 1" 0>1' West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Va to 1" ❑ > 1" Facade Description:

I Roof

Debris: ❑ No Visible /Fine Layer ❑%to1" 0>1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑'% to 1" 0> 1" Floor. Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

Date: / IG2002 Inspection by: Name: AP Agency: DP Name: Agency:

NYC-WTC 000092997