WTC Facade Inspection Form, South Street

NYC 9111 Public Portal Document

WTC Visual Survey Form /O6oao ' Premise Address: e I Block:. Residential p Commerc1al Name of Building: Lot pp Mix UseD Other # of Stories: AKA's: Building ner!Ma gement: Telephone Number ( ) Name: L FAX: Address: On Site Contact: Name: ' ' Telephone Number Building Owner Management Activities Interior Survey Performed Yes Q No Exterior Survey Performed Yes a 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 D Yes

Visual Inspection Results: Facade: Inspected Debris North N/A Yes No No Visible/Fine Layer 3 to 1 al' South N/A Yes No No Visible/Fine Layer % to 1' >1 East N/A Yes No No Visible/Fine Layer i4 to 1' >1' West NIA Yes No No isible/Fine Layer % to 1' >1' Facade Description:

Roof Debris: D ISIbIe /Fine Layer .9 N to 1' r] > 1' Description:

Setbacks WA~ Floor:___ Debris: No Visible/Fine Layer 34 to 1' al' Floor:___ Debris: No Visible/Fine Layer % to 1' > 1' Floor:___ Debris: No Visible/Fine Layer h to 1' > 1" Floor:___ . Debris: No Visible/Fine Layer % to 1' > 1' Floor.___ Debris: No Visible/Fine Layer % to 1' > 1' Comments

NYC-WTC-000117183