Facade inspection form, 273 Water Street

NYC 9/11 Public Portal Document

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WTC Visual Survey Form Premise Address:

Block: ResidentialD Commercial Name of Building: Lot: Mix Use fl 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 s ❑ No 'No Visible/Fine Layer ❑ % to 1' ❑ > 1' South [EN1A ❑ No 0110 Visible/Fine Layer [3% to 1' ❑ >V East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'h to 1' 0>1' West ❑ N/A 0 Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1' 0>1' Facade Description:

Roof

Debris: 2' o Visible /Fine Layer .❑

% to 1' 0>1' Description:

Setbacks N/A L] Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to V 0>1' Floor. Debris: ❑ No Visible/Fine Layer ❑ Y: to 1' ❑>1' Floor. Debris: ❑ No Visible/Fine Layer 0 Ys to V ❑>1' Floor. Debris: ❑ No Visible/Fine Layer ❑ 7h to 1' ❑>1' Floor. Debris: ❑ No Visible/Fine Layer [] Va to 1' 0> 1' Comments

Date: 120 12002 Inspection Team: Name: Agency: • Name: rtUUc Agency: ENTERED NYC-WTC 000113810