License agreement for facade cleanup, 22 Thames St, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Addres 2

Block: Residential 0 Commercial Name of Building: Lot: Mix Use ❑ Other #of Stories: AKA's: Building Owner/M na ement: Telephone Number: ( ) Name: FAX:( Address: OnSiteContact:fl Name: L 'T" Telephone Number: 30 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 J Yes

Visual Inspection Results: Facade: Inspected ris North ❑ N/A Yes ❑ No o Visible/Fine Layer ❑ Y to 1" ❑ > 1" South ❑ N/A ❑ Yes ❑ No fNo Visible/Fine Layer ❑ % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No o Visible/Fine Layer ❑ % to 1" 0>1" Facade Description:

Roof

Debris: o Visi a /FLe Laxer ❑'/ to 1"1 J [~ 1" Description: w~ -~tO I" Inr `C"

Setbacks N/A [] Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1"

Comments M 1 ' Gt~QA LAVc tiv'GIlS

wV'6" ' l"lAQ Ao 1 I~w~ ~W w 2~► "' tti 1A ~ c> '-4"-' PJ e J 7 Date: /i 120,02 Inspection Team: Name: _' '4, Agency: Name: Agency:

NTERE ) NYC-WTC- 000116124