49 JOHN STREET 1001199 78/28

NYC 9/11 Public Portal Document

WTC Visual Survey Form BI~1A I O o 119 q Premise Address:

Block: 7g Resident( Commercial Name of Building: Lot: 2.3 Mix Use ❑ Other ❑ # of Stories: AKA's: Building OvçperfManagement Telephone Number: ( ) Name: -rc FAX: Address: Q, On Site Contact: Name: ' 'p,-( ~ Q~e-.~,~~~.. 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 4es ❑ No Locations: Copies of All Reports and Data Requested es

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ to 1" Y2 ❑ > 1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑'/2 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description: v P

Roof

Debris: o Visible /Fine ayer ❑ Y2 to 1" . ❑ > 1" 'I Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ '/2 to 1" ❑ > 1"

Comments

Date: — / 1 /2002 Inspection Team: Name: Agency: 4,JSj1C 6' Name: Agency:

NYC-WTC 000093182