WTC Facade Inspection Form, 10 South Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form PremL , ress: Block: Re identialD Commercial Name of Building: Lot: Mix UseD Other # of Stories: AKA's: Building Owner/Management Telephone Number. ( ) Name: Ct O7 FAX: Address: On Site Contact: Name: Telephone Number Building Owner Management Activities Interior Survey Performed 0 Yes 0 No Exterior Survey Performed ❑ Yes 0 No General Clean Up ❑ Yes 0 No Locations: ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring ❑ Yes 0 No Locations: Copies of All Reports and Data Requested J Yes

Visual inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes 0 No ❑ No Visible/Fine Layer Di4tol' 0>1' WIN South East West iN/A ❑ N/A ❑NIA D es 0 No Yes 0 No ❑Yes0No ❑ No Visible/Fine Layer 0 % to 1' ❑ No Visible/Fine Layer 0Yato l' ❑ No Visible/Fine Layer []'h to 1' 0" 1w 0>1' Facade Description:

Roof Debris: o Visible /Fine Layer I-]% to 1' 0>1' Description:

Setbacks NIA ]q Floor. Debris: 0 No Visible/Fine Layer z] 34 to 1' 0>1' Floor Debris: [] No Visible/Fine Layera % to 1' 0>1. Floor. Debris: 0 No Visible/Fine Layer 034 to 1' 0>1' Floor. Debris: 0 No Visible/Fine Layer ❑ j% to 1' 0>1' Floor. Debris: 0 No Visible/Fine Layer [] % to 1' 0>1' Comments

Date: l /2002 Inspection Team: Name: —. Agency: Name: Agency: ENTERED

NYC-WTC-000117201