130 WILLIAM STREET; 1001187, 77/15

NYC 9/11 Public Portal Document

* WTC Visual Survey Form BN 100118 Premise Address: 130 W I I ll a rr) 3+ree+ Block: 7'1 Residential 0 Commercial 0 Name of Building: Lot: I$ Mix Use ❑ 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 Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" ❑ > 1" Facade Description:

Roof

Debris: Visible /Fine Layer ❑ % to 1" ❑ > 1" Description:

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 ❑ V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1"

Comments

Date: dl / &a/2002 Inspection by: Name: AP Agency: I)EP V Name: Agency:

NYC-WTC-000110530