7 STATE STREET Block: 9 Lot: 7 BIN: 1000019 Shrine of St. Elizabeth Ann Seton

NYC 9/11 Public Portal Document

- WTC Visual Survey Form r.: Prornis i Address:

Block: Cf Residential D Commercial p Name of Building: Lot: Mix UseD Other # of Stories: AKA's: Building Owner/Mana ement Telephone Number. ( ) Name: 0 2F 1s d&Awt FAX: Address: On Site- Contact: Name: ' Telephone Number. Building Owner Management Activities Interior Survey Performed Yes a No Exterior Survey Performed Yes [] No General Clean Up D Yes No Locations: ACM Clean Up Yes No Locations: Air Monitoring Yes ❑ No Locations: Copies of All Reports and Data Requested 0 Yes

Visual Inspection Results: Facade: Inspected Debris North [] N/A Yes ❑ No No Visible/Fine Layer to 1 > 1' 8301*

r South [] N/A Yes No No Visible/Fine Layer l' East [] N/A Yes No No Visible/Fine Layer 1' [] > 1' West N/A Yes No No Visible/Fine Layer 1' EJ > 1' Facade Description: z-,

Roof Debris: 36o Visible /Fine Layer 0 34 to 1' 1J>1. Description:

Setbacks WAN( Floor Debns: No VisibleFine Layer i'a to 1 >1 Floor____ Debris: No Visible/Fine Layer % to V > 1' Floor. Debris: No Visible/Fine Layer % to 1' > 1' Floor.__ Debris: No Visible/Fine Layer % to 1' > 1' Floor.____ Debris: No Visible/Fine Layer 34 to 1' > 1'

Comments

Date: */ 12002 Inspection Team: Name: ~—' Agency: Name: _Agency: ENT 3 F r)

NYC-WTC-000116786