21 SOUTH WILLIAM STREET Block: 29 Lot: 49 BIN: 1000847 23 South William St., 45-47 Stone Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: . I ` i 0 Block: Residential 0 Commerci& Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management 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 Q No Locations: Copies of All Reports and Data Requested J J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Vsible/Fine Layer ❑ %a to 1" 0>1" South ❑ NIA ❑ Yes ❑ No Q No Visible/Fine Layer ❑ Ya to l" 0>1" East ❑ NIA DYesDNo ❑ No Visible/Fine Layer ❑ Ya to l" 0>1" West ❑ N/A DYes [] No ❑ No Visible/Fine Layer Q % to 1" ❑ > 1" =wwww~w ~ww w~7w~Sww•

Roof

Debris: ❑ No Visible /Fine Layer ❑ ato 1 " 0 >1" - Description: , A

Setbacks N/A ❑ Floor. Debris: 0 No Visible/Fine Layer 034 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" 0> 1" Floor: Debris: ❑ No Visible/Fine Layer Q % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ h to 1" 0>1"

Comments 7

Date: Inspection Team: Name: Cr. v T " `-~ Agency: I Name: Agency:

NYC-WTC- 000116949