WTC Visual Inspection Form, 15 Broad Street

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WTC Visual Survey Form Premise A ss: Em .'X cha. n e P' ac e Block: Residential Commercial U Name of Building: Lot: Mix Use EJ Other # of tories: AKA's: Building Owner/ aagement: Telephone Number: )135. 1n`3 Name: FAX: ( ) Address: On Site Contact: Name: A03 - Telephone Number: ( ) (C3S 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 ❑ No Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No o Visible/Fine Layer ❑ 1/2 to 1" ❑ > 1" South ❑ N/A 7Yes ❑ No o Visible/Fine Layer III 1/2 to 1" ❑ > 1" East ❑ N/A Yes ❑ No o Visible/Fine Layer ❑'/z to 1" ❑ > 1" West ❑ N/A Yes ❑ No fl No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Facade Description:

Roof

Debris: No Visible /Fi to 1" n> 1" Description: 1rrc~E 1n m-.

Setbacks N/A ❑ Floor: Q Debris: ❑ No Visible/Fine Layer Q % to 1" ❑ > 1" Floor: L Debris: ❑ No Visible/Fine Layer ½ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 9½ to 1" ❑ > 1"

Comments

Date: / 162 /2002 Inspection by: Name: rin Tt p t gency: EP Name: Agency:

NYC-WTC- 000118702