54 LEONARD STREET Block: 176, Lot: 25, BIN: 1001968 AKA:

NYC 9/11 Public Portal Document

WTC Visual Survey Form /0OJ yd R' Pre,rn Address:

Block: Residential Commercial Name of Building: Lot ). y Mix Use 0 Other 0 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 p Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 034t01' 0>1' South ❑N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑ h to 1' 0>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1' 0>1' West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ y4 to 1' 0>1' Facade Description: n n - -

Roof

Debris: No Visible /Fine Layer •0 34 to 1' ❑ > 1' Description:

Setbacks N/A(" Floor Debris: ❑ No Visible/Fine Layer ❑ % to V 0>1' Floor____ Debris: ❑ No Visible/Fine Layer ❑ ~4 to V ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' ❑ > 1' Debris: ❑ No Visible/Fine Layer ❑ y4 to 1' Floor: Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' 9> > 1' 1'

Comments

Date: c/ t2R002 Inspection Team: Name: Agency. Name: Agency: NTERE&.

NYC-WTC 000093332