90 WILLIAM STREET; 1001114, 68/22

NYC 9/11 Public Portal Document

WTC Visual Survey Form tool

fl q Premise Address: nD Wilharn ree+ Block: Residential 0 Commercial 1 Name of Building: Lot• Mix Use EJ Other # of Stories: AKA's: C Building Owner/Management: Telephone umber: ( ) 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 0 Yes ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No No VSible/Fine Layer ❑ Y2 to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑'/2 to 1" 0>1" East ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer 0 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ V2 to 1" ❑ > 1" Facade Description:

Roof

Debris: Description: F No Visible /Fine Layer ❑%to1" ❑>1"

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

Comments

Date: Oc / Ito /2002 Inspection by: Name: AP Agency: Name: Agency:

NYC-WTC-000110346