13 HARRISON STREET Block: 180, Lot: 7506, BIN 1002035

NYC 9/11 Public Portal Document

WTC Visual Survey Form /O(5 05 Premise Address:

Block: (ic Residential Comrnercial9 Name of Building: Lot: Mix Use Other ti'~V' # of Stores: 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 Q No Locations: ACM Clean Up _ ❑ Yes ❑ No Locations: Air Monitoring D Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Ins ected . Debris North t] N/A s 0 No ffo Visible/Fine Layer i4 to 1' 0:-.1, South ❑ N/A YesQNo o Visible/Fine Layer %to 1' 9>1' East ON/A ❑Yes❑No O No Visible/Fine Layer %to 1' 0>1' West N/A L] YesQNo 0 No Visible/Fine Layer ❑ % to 1' 9>1' Facade Description:

Roof

Debris: r No Visible /Fine Layer .0 % to 1' 9>1' Description:

Setbacks WA Floor___ Debris:D No Visible/Fine Layer y4 to 1' Floor Debris: Q No Visible/Fine Layer 34 to 1' Floor____ Debris: Q No Visible/Fine Layer 3 to V Floor.____ Debris: j] No Visible/Fine Layer 34 to 1' Floor___ Debris: ❑ No Visible/Fine Layer % to 1'

Comments

. .I

Date: / /(12002 Inspection Team: Name: Agency: Name: Agency: T E R 11

NYC-WTC 000093572