90 JOHN STREET BI 69 lOT. 7502/1001127

NYC 9/11 Public Portal Document

WTC Visual Survey Form 100 t t 2,-7 Premise Address: . go c-r Block: 6 C1 ResidentialD Commerciaip Name of Building: Lot: —1 s o ô' Mix UseD Other # of Stories: AKA's: I S -3 Pt -1-7 S-r 2~ E r 2.0- 2~{ G-o L.) S Building Owner/Management Telephone Number: ( ( ) Name: FAX: Address: On Site Contact: Name: ' ' Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes 0 No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring D Yes ❑ No Locations: Copies of All Reports and Data Requested j J Yes

Visual Inspection Results: Facade: Inspected bris North ❑ N/A ❑ Yes ❑ No 7J No Visible/Fine Layer D % to 1" ❑ > 1" - South ❑ N/A ❑ Yes ❑ No UJNoVisiblelFineLayer ❑ % to 1" 0>1' East ❑ N/A ❑ Yes ❑ No JJJNoVisibIefFineLayer ❑'/ to l" 0>1. West ❑ N/A ❑ Yes ❑ No fl NoVisiblelFineLayer ❑ % to 1" 0>1' Facade Description: I__________________________ _____________

Roof

Debris: jjj No Visible /Fine 'Layer 0 % to 1' ' 9> V -. 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 ❑ % to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer D % to 1" _] > 1" Comments

Date: /2 02002 Inspection Tear flame: b A. ~,~~o &c, - 7 os Agency: _LC )C(' Name: Agency:

IENTERF? NYC-WTC 000093157