135 JOHN STREET Block: 75 Lot: 8 BIN: 1001164

NYC 9/11 Public Portal Document

WTC Visual Survey Form r se Address:

Block: Residential 0 C menial Name of Building: Lot: Mix UseD Other # of Stories: c . AKA's: Building Owner/Management Telephone Number. ( ) Name: fv\Q.-y C4i r RE?S 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 L] Yes ❑ No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑/2to1' 0>1 ' South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ 34 to 1' 0>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1' 0>1' West ❑N/A ~~(es❑No ❑ No Visible/Fine Layer ❑ % to 1' 0>1' Facade Description: ()

Roof

Debris: o Visible /Fine Layer ❑ 36 to 1' r] > V Description:

Setbacks N/A'f~ Floor. Debris: 0 No Visible/Fine Layer ❑ 34 to V 9>1. Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' 9> 1' Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1' 0>1' Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' 9>1' Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1' Comments

Date: / Ro02 Inspection Team: Name: Agency: TE REa Name: Agency:

NYC-WTC 000093311