WTC Facade Inspection Form, 15 South Street

NYC 9/11 Public Portal Document

WTC Visiiaf SurveyForm 100000(19 Premise Addre Block: S' Residential Commercial Name of Building: Lot - 7 5°' Mix usetJ Other # of Stories: 2.. AKA's: i+2+ 2 Building Owner/Management Telephone Number: ( Name: k c 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 ACM Clean Up Air Monitoring 0 Yes No Locations: Yes No Locations: Li Yes 9 No Locations: Copies of All Reports and Data Requested 0 Yes

visual inspection Resuns: Facade: Inspected • • Debris North ❑ N/A 9 Yes No No Visible/Fine Layer 36 to 1' > 1" South N/A Yes No No Visible/Fine Layer 34 to 1' > 1' East N/A Yes No No Visible/Fine Layer 34 to? > 1" West N/A Yes No (~ No Visibie/Firis Layer H%tol" > 1" Facade Des ption:

Roof Debris: 0 No Visible /Fine Layer 9 % to 1' 0>1' Description:

Setbacks N/AJZJ Floor: Debris: No Visible/Fine Layer 34 to 1' >1' Floor. Debris: No Visible/Fine Layer %4 to? >1' Floor. Debris: No Visible/Fine Layer 14 to V >1' Floor. Debris: No Visible/Fine Layer 34 to 1' > 1' Floor:____ Debris: - No Visible/Fine Layer % to 1' >1' Comments

Date: 4/ 2.7 n00. iD Inspection Team: Name: T). ShC _1AAgency:OEP Name: Agency:

NYC-WTC-000117211