10 HARRISON STREET Block: 181, Lot: 2, BIN 1002067

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: -

Block: Residential- Commercial Name of Building: Lot: Mix Use Other # 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 ❑ es ❑ No [,No Visible/Fine Layer ❑34to 1' 0>1' South ❑ N/A - es ❑ No No Visible/Fine Layer ❑34to 1' 0>1' East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ %to 1' 0>1' West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑"ato1' 0>1' Facade Description:

Roof

Debris: o.Visible /Fine Layer 934t01' 9>1' Description:

Setbacks N/A ❑ Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ K to? ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1' ❑ > 1' Floor. Debris: 0 No Visible/Fine Layer ❑ 34 to V E3> 1' Comments

Date: ' I 1 12002 Inspection Team: Name: Agency: ENTERS'' Name: Agency:

NYC-WTC 000093546