280 RECTOR PL 1065199, 16/7506

NYC 9/11 Public Portal Document

WTC Visual Survev Form Premirse Address: )

Block: Residential CommercialD Name of Building: Lot: p Mix Use ❑ Other ❑ # of Stories: AKA's: Building Owner/MAnag , n ent: Telephone Number: ( 2i 2) Name: S ~~.~ FAX: ( ) I+ -7 7 c Address: - On Site Contact: Name: kic"1 Telephone Number: (21 Z) Building Owner Management tivities Interior Survey Performed Yes ❑ No Exterior Survey Performed El 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 j J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" South ❑ N/A [aYes ❑ No ❑ No Visible/Fine Layer ❑ Yz to 1" ❑ > 1" East ❑ N/A E] Yes ❑ No ❑ No Visible/Fine Layer ❑ Yz to 1" ❑ > 1" West ❑ N/A [Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Facade Description: ,.

Roof

Debris: ❑ No Visible /Fine tayer ❑ Y2 to 1" 1 ~"' ❑ > 1" 1 Description: dL

Setbacks N/A Floor: 0 Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: I, / /2002 Inspection Team: Name: ~~ Agency: Name: L; , Agency:

NYC-WTC-000114100