Site identification label for 280 Rector Place

NYC 9/11 Public Portal Document 1 t~ WTC Visual Survey Form Premise Address:

Block: I Residential Commercial Name of Building: Lot: Mix Use ❑ Other # of Stori s: 4 AKA's: Building O ner Mama gme t: Telephone Number: ~12a~j ,> > 3- Name: I cgte-C ~° FAX: ( Address: On Site Name: ContactTl_~ Telephone Number: ( ) Building Owner ManagemenAttivities Interior Survey Performed Yes ❑ No Exterior Survey Performed [Yes ❑ No General Clean Up 21 es ❑ No Locations: ACM Clean Up ❑ Yes ['No Locations: Air Monitoring EYes ❑ No Locations: Copies of All Reports and Data Requested Yes

Visual inspeuUUn rwbuIL Facade: Inspected Debris North 0 N/A [Yes ❑ No ❑ No Visible/Fine Layer ❑ to 1" Y2 ❑ > 1" South ❑ N/A ❑'Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A EYes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" West ❑ N/A 0 Yes ❑ No ❑ No Visible/Fine Layer ❑'/2 to 1" ❑ > 1" Facade Description: / (.J

Roof

Debris: No Visible /Fine tayer ❑'/2 to 1" •1 441 •1 :1>1" Description:

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

Date: Inspection Team: Name: l Agency: Name: i2 L,.1 Agency:

NYC-WTC-000114095