Building information form, 150 Street, BN 1001280

NYC 9/11 Public Portal Document

WTC Visual Survey Form BN-A 10012$0 Promise Address: Milian-) ' ,5+ree~- Block: q3 Rlesiidential Commercial O 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 brie North ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑%tol" 0>1" South ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑%to1" 0>1" East ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ % to l" 0>1" West ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑%tol" 0>1" Facade Description:

Roof

Debris: No 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: J No Visible/Fine Layer 0 % to 1" ❑ > 1" Floor. Debris: JJ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments

Date: /J 7 /2002 Inspection by: Name: AP Agency: DC --P Name: Agency: V

NYC-WTC-000110668