83 GREENWICH ST 1000799, 19/19

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: •

Block: Residential Commerci Name of Building: Lot: Mix Use J Other # of Stories: J AKA's: Building Owne Management: Telephone Number: ( ) Name: 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 ❑ 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 1" D>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Ya to 1" E]> 1" East ❑ N/A `®'Yes ❑ No 'No Visible/Fine Layer El 1/2 to 1" ❑ > 1" West ❑ N/A , 'es ❑ No No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description:

Roof a , Debris: -co Visible /Fine Layer ❑Yato1"' ❑>1" - Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ Va 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 ❑ V to V ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ 2 to 1" ❑ > 1"

Comments

Date: Inspection Team: Name: r` W' ''•' Agency: Name: Agency:

»NTERFI NYC-WTC 000128373