80 Beaver Street 127 Pearl Street BIN: 1000834

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address:

Block: Residential D Commercial Name of Building: Lot: Mix Use J Other h 9R # of Stories: AKA's: 127PC/J-R L SrRE€ r Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site Contact: -----------------------------------------------------------, Name: - lcH rcu~ Telephone Number: P11 Building Owner Management Activities -.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.--.-.-.-.-.-.-.-...- Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes 0 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 ❑ No Visible/Fine Layer ❑ % to l" O>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Vato1" ❑>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Vato1" ❑>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" O>1" Facade Description:

Roof

Debris: E' No Visible ❑ Va to 1" ❑ > 1" Description:

Setbacks N/A Floor. 9 Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"

Comments

Date: q//2002 Inspection Team: Name: RC 7/ i' /J' ' Agency: .2) E.? NTERE Name: Agency:

NYC-WTC-000119005