140 WILLIAM STREET; 1001189, 77/20

NYC 9111 Public Portal Document

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• WTC Visual Survev Form B N ' 100 11$ ~f Premise Address: IH0 wt'i ii I a rr- free - q (o Fu I+on 5free-i Block: 7'? Residential 0 Commercial Name of Building: Lot: 20 Mix UseD 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 11 1,4to11 ❑ > 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer f.J % to 1" ❑ > 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" 0>1" Facade Des~tio K~ u~

Roof

Debris: ❑ No Vis" 1 /Fin a Y2 to 1" 0>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 ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: IS) / /2002 Inspection by: Name: A? Agency: DE P Name: Agency:

NYC-WTC 000110616