84 WILLIAM STREET 1001113, 68/16

NYC 9/11 Public Portal Document

WTC Visual Survey Form R I~-* 10 01113 Premise Address: I UV I I I arn o+ree f Block: (08 Residential 0 Commercial j Name of Building: Lot: (b Mix Use 0 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 ❑ Yes

Visual Inspection Results: Facade: Inspected D ris North ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ Y to 1" 0>1" South ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ Y to 1" 0>1" East West ❑ N/A ❑ N/A Facade Description: ❑ Yes ❑ No ❑ Yes ❑ No F o Visible/Fine Layer o Vsible/Fine Layer ❑ % to 1" ❑ Y2 to 1" 0>1" 0>1"

Roof

Debris: ~i$ o Visible /Fine Layer ❑ % to 1" ❑ > 1" Description: T

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ 4 to 1" ❑ > 1" Comments

Date: //2002 Inspection by: Name: AP Agency: D6 P Name: Agency:

NYC-WTC-000110340