62 WILLIAM STREET; 1001013, 41/24

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: - ` I. t1— Block: Residential 0 CommerciØ Name of Building: Lot: Mix Use Other # of Stories: AKA's: Building Own /Management: Telephone Number: (, ) Name: FAX: Address: On Site Contact: Name: Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed 0 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 Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'% to 1" ❑ > 1' South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ h to 1' ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A s ❑ No ❑ No Visible/Fine Layer/a to 1" ❑ > 1" Facade Description:

Roof Debris: ❑ No Visible /Fine Layer ❑ Va to 1' ` ❑ > 1'

Setbacks N/A ❑ Floor Debris: 0 No Visible/Fine Layer ❑ % to 1 ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer 0 Va to 1' ❑ > 1' Floor. Debris: ❑ No Visible/Fine Layer ❑ s to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/a to 1' ❑ > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ i4 to 1' ❑> V Comments

Date: _1 /2002 Inspection Team: Name: Agency: Name: Agency: 'ENTERE

NYC-WTC- 000110338