58 THOMAS STREET Block: 147 Lot: 24 BIN: 1066414

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1 O(oCo1J 1 tI remise Address:

Block' Cj1 Residential CommercialD Name of Building: Lot: Mix Use Other # of Stories: AKA's: Building Owner/Management ,t Telephone Number. ( ) Name: FAX: Address: On Site Contact Name: " • Telephone Number. 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 EYes

Visual insDection Results: Facade: Inspected Debris North ❑ N/A 2] Yes ❑ No I No Vsible/F a r ❑%tol" 0>1" South ❑ N/A Yes ❑ No No Visible/ 3r 014to1" ❑>1" East N/A DYesDNo ❑ No Visible/Fine Layer ❑ Ya to 1" 0>1" West E N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑ 4to1" 0>1" Facade Description:

Roof

Debris: 5a No Visible ❑ Va to 1" ❑ > 1" Description:

Setbacks N/A j Debris: ❑ No Visible/Fine Layer 0>1" Floor: Floor____ Floor: Debris: ❑ No Visible/Fine Layer 0 3. to 1" a to 1" Debris: ❑ No Visible/Fine Layer ❑ 6 to 1" ❑ > 1" 0>1" Floor. Floor____ Debris: ❑ No Visible/Fine Layer 0 a to 1" Debris: ❑ No Visible/Fine Layer ❑ % to 1" B20 0>1" 1"

Comments

Date: 4 11312002 Inspection Team: Name: RA'rr ,l r Agency: DE. Name: Agency:

NYC-WTC-000116745