License agreement for debris cleanup, 25 Maiden Lane, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 0 0 1 Oq Premise Address: n5 v

5 maiden kne_ Block: Lot: 14 Residential Mix Use 0 Commercial 0 I Name of Building: Other # of Sto es: 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 D Yes ❑ No Locations: Copies of All Reports and Data Requested Yes

YA Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer to 1" ❑> 1" East ❑ N/A ❑Yes ❑ No ❑ No Visible/Fine Layer to 1" ❑> 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer to 1" ❑ > 1" Facade Description:

Debris: ❑ No Visible /Fine Layer to? D>1 Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑ Y to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'h to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ h to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ 1/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 16 to 1" ❑ > 1" Comments

Date: / !S /2002; Inspection by: Name: AP Agency: DEP Name: Agency:

NYC-WTC 000102204