90 JOHN STREET bi. 76Lot. 11/1001180

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: . l Block: I Residential 0 Commer al D Name of Building: Lot I Mix Use çôther 0 of Stories: I AKA's: Building Owner/Ma ement• Telephone Number ( ) Name: —G FAX: Address: On Site Contact: Name: • CJ~— V Ow~.~0LAs le hone .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 Inscection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'r4 to 1' 0>1' South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'r4tol' 0>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer E]'r4 to 1' 0>1' West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ i4 to l' 0>1' Facade Description: , 0

Root

Debris: o Visible /Fine Layer .❑ ~4 to 1' 0>1' Description:

Setbacks N/A ❑ Floor: Debris: 0 No Visible/Fine Layer ❑ % to 1' 0>1. Floor____ Debris: ❑ No Visible/Fine Layer ❑ i4 to 1' ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer ❑'% to 1' ❑ > 1' Floor____ Debris: ❑ No Visible/Fine Layer ❑ i4 to 1' ❑ > 1' Floor. Debris: 0 No Visible/Fine Layer ❑ fs to V ❑ > 1' Comments

Date: Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000093166