License agreement for exterior cleaning, 65 Liberty Street

NYC 9/11 Public Portal Document

.WTC Visual Survey Form 16O I O51J Premise Address: 55 Li be r -r L jiree+ Block:6t Residential D Commercial Name of Building: Lot: Mix Use ❑ Other ❑ # of ories: 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 ❑ Yes

Visual Inspection Results: Facade: Inspected pebr' North ❑ N/A ❑ Yes ❑ No J Nft Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description:

I Roof

Debris: If No Visible /Fine Layer ❑ % to 1" ❑ > 1" 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 ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ 1/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Comments

Date: _ /5/2002 Inspection by: Name: ,4P Agency: DEP Name: Agency:

NYC-WTC 000093480