123 WILLIAM STREET; 1079064, 78/14

NYC 9/11 Public Portal Document

WTC Visual Survey Form It)-74Dr, I Premise Address: 123 W%u.1AM S1-~ Block: 7, Residential 0 Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: Name: ' -loc,.. 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 0 Yes ❑ No Locations: Copies of All Reports and Data Requested fl Yes

vlaual inspecuon ResUIzs: Facade: Inspected Debris North ❑ N/A fl Yes ❑ No ❑ No Visible/Fine Layer ❑ /2 to 1" O>1 ' South ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer % to 1" [:]>I* East ❑ N/A Q Yes ❑ No ❑ No Visible/Fine Layer ❑%to1' ❑>1" West ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer J''/ to 1" 0>1w Facade Description:

Roof

Debris: 9No Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑Y2 to 1" ❑ > 1' Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1' Floor: Debris: ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 % to 1' ❑ >V Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1'

Comments

Date: o S / '30/2002 Inspection Team: Name: `DA /Ao 20 Agency: _DcET Name: Agency: ENTERE3

NYC-WTC 000110463