9 OLIVER STREET Block: 279 Lot: 14 BIN: 1003368 AKA's:

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: OLd c S Block: Residential Commercial p Name of Building: Lot f Cf Mix UseD Otherp # of Stori AKA's: Building a anage ent: Telephone Number. ( ) Name: FAX: Address: On Site Co ct: /' ,L iOu3 - -1 o(C( Name: ' ' .' Telephone Number. Building Owner Management Activities Interior Survey Performed Yes No Exterior Survey Performed Yes No General Clean Up Yes 0 No Locations: ACM Clean Up Yes 0 No Locations: Air Monitoring Yes ❑ No Locations: Copies of All Reports and Data

Requested Yes Visual inspection Results: Facade: Inspected Debris North L]N/A 9Yes9No No Visible/Fine Layer %to V 0>? South N/A Yes [] No No Visible/Fine Layer %to1' ❑>1' East N/A Yes ❑ No No Visible/Fine Layer %to 1 0>? 03-10 West N/A Yes ❑ No No Visible/Fine Layer 034t01 Facade Description: () n „

Roof Debris: No Visible /Fine Layer .934 to? JJ > 1' Description:

Setbacks N/A Floor: Debris: Q No Visible/Fine Layer 34 to? > 1' Floor____ Debris:[] No Visible/Fine Layer H%tolm > 1' Floor Debris: j] No Visible/Fine Layer ❑ h to 1' > 1' Floor____ Debris: No Visible/Fine Layer % to 1' > 1' Floor____ Debris: No Visible/Fine Layer % to 1' >1' Comments

Date: Inspection Team: Name: Agency. E Name: Agency:

NYC-WTC 000116041