119 SOUTH STREET Block: 97 Lot: 1 BIN: 1001322 42-44 Peck Slip, 42 Peck Slip, 116 South Street, 118 South Street

NYC 9/11 Public Portal Document

!do 112M WTC Visual Survey Form Premise Address:

Block: Residential Commercial ame of Building: Lot: Mix Use Other # of tories: AKA's: t • • Building Owner/Management elephone 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 9 Yes No Locations: Copies of All Reports and Data Requested DYes

Visual Insoection Results: Facade: Ins cted Debris

r North 1afA as No No Visible/Fine Layer /~ to 1 '

South 9N1A es No No Visible/Fine Layer % to l' >1' East ❑ N/A Yes No No Visible/Fine Layer i4tol' >1' West ❑ N/A Yes No No Visible/Fine Layer h to l' >1'' H301 Facade Description:

Roof Debris: No Visible /Fine Layer .9 34 to 1' 9>1' Description:

Setbacks N/AD Floor_, Debris:DNo Visible/Fine Layer ❑ % to 1' 9>1' Floor. Debris: No Visible/Fine Layer % to V > 1' Floor____ Debris: No Visible/Fine Layer % to 1' 0>1' Floor: Debris: No Visible/Fine Layer % to 1' >1• Floor___ Debris: No Visible/Fine Layer 34 to 1' 0>1'

Comments

Date: t/Qnoo2 inspection Team: Name: Name: • Agency: ENTERED NYC-WTC 000116893