68 THOMAS STREET Block: 147 Lot: 7504 BIN: 1001616

NYC 9/11 Public Portal Document

M WTC Visual Survey Form 1 Ah I t 1.C. Pre Ise Address: 9. 6~~ ;? m4 S$ 2/- Block: Residential Commercial fJ Name of Building: Lot: Mix Use 0 Other # of Stories: 5 AKA's: Building Owner/Management Telephone Number. ( ) Name: FAX: Address: On Site Contact 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 ❑ No Locations: Air Monitoring ❑ Yes[] No Locations: Copies of All Reports and Data Requested Yes visual insuectton Results: Facade: Ins cted Debris North ❑ N/A esQNo No Visible '/ to l" 0>111 South ❑ N/A esQNo No Visible/F3 Byer 14to1" 0>1" East N/A Yes ❑ No O No Visible/Fine Layer ❑%to1" 0>1" West W N/A D ❑ No Yes ❑ No Visible/Fine Layer 014to1" 0>1" Facade Description:

Roof Debris: No Visible ❑ Y: to 1" 0>1" Description:

Setbacks N/A 0 Floor. Floor: Debris: Q No Visible/Fine Layer 034 to I . Debris: No Visible/Fine Layer ❑ r4 to 1 ~ " H.>1"11t

Floor. Debris: [] No Visible/Fine Layer 14 to 1"' ❑ > 1" Floor. Debris: [] No Visible/Fine Layer 2 to 1" ❑ > 1" Floor: Debris: [] No Visible/Fine Layer h to 1" 0> 1" Comments

Date: 4 f 13 12002 Inspection Team: Name: Rai 'S4' t Agency: .des , Name: Agency: ENTE RED

NYC-WTC-000116756