WTC Facade Inspection Form, 18-19 [location]

NYC 9/11 Public Portal Document ni-k7l A 2 -iI iii Premise Address: g— t igo516y w jock: ResidentialLi CommercialZ I Name of Building: Lot: Mix UseD Other # of Stories: AKA's: Building Owner/Management: Telephone Number. ( Name: N AX: Address: On Site Contact Name: ' ' Telephone Number Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes 0 No General Clean Up ❑ Yes 0 No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes 0 No Locations: Copies of All Reports and Data RequestedD Yes visual inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ h to 1" 0>1" South 9 N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 34 to 1" 0>1" East JJ N/A QYes ❑ No ❑ No Visible/Fine Layer %tot" ❑>1" West N/A Yes 0 No ,No Vislble/Fii'ia DYato1" 0>1" Facade Description:

Roof Debris: 0 No Visible/Fine Layer ❑ 34 to 1" 9>1" Description:

Setbacks NWA,j Floor. Debris: ❑ No Visible/Fine Layer ❑% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 34 to 1" 0>1" Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: L]No Visible/Fine Layer ❑ % to 1" 9>1" Floor. Debris: Q No Visible/Fine Layer ❑ 34 to 1" 0>1' Comments

Date: / /2002 Inspection Team: Name: t. 4 P. Q. &.Agency: Name: Agency:

ZNTE-REID NYC-WTC 000117220