11 OLIVER STREET Block: 279 Lot: 13 BIN: 1003367 AKA's:

NYC 9/11 Public Portal Document

WTC Visual Survey Form Preens a Address: ,._.

Block: Lot 9 Residential Mix UseD Other Commercial p Name of Building:

# of Stories: t4.. AKA's: Building Own r/Man gement: Telephone Number ( ) Name: `Tr G FAX: Address: On Site Contact: 1 Name: " " Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed Yes [] No General Clean Up Yes No Locations: ACM Clean Up Yes 0 No Locations: Air Monitoring Yes ❑ No Locations: Copies of All Reports and Data RequestedD Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes No No Visible/Fine Layer % to l' 9>1' South [] N/A Yes No No Visible/Fine Layer 34to1' 0>1' East ❑ N/A Yes No No Visible/Fine Layer % to l' 0>1' West [j N/A Yes [] No No Visible/Fine Layer %to1' 0>1' Facade Description: n 0

Roof Debris: Vo Visible /Fine Layer .9 34 to l' ❑ > 1' Description:

Setbacks N/A Floor Debris: 0 No Visible/Fine Layer ❑ % to 1' 0>1' Floor____ Debris: ❑ No Visible/Fine Layer [] h to >1' Floor Debris: ❑ No Visible/Fine Layer ❑ 4 to 1' is

> >. Floor____ Debris: No Visible/Fine Layer % to? Floor____ Debris: E3 No Visible/Fine Layer 34 to l' 9>1' Comments

Date: 3 I /2002 Inspection Team: Name: ti--y Agency: Name: Agency: ENTER NYC-WTC 000116044