246 FRONT ST. / 267 WATER ST.

NYC 9/11 Public Portal Document

. .. WTC Visual Survey Form Premise Address:

Block: Residential 0 Commercial z me of Building: Lot Mix Use EJ Other t # of o es: AKA's: Building Owner/Management Telephone Number. ( ) Name: -- I FAX: Address: On Site' Contact: Name: ' .. . Telephone .Number Building Owner Management Activities Interior Survey Performed Yes Q No Exterior Survey Performed Yes No a

General Clean Up Yes No Locations: ACM Clean Up Yes No Locations: Air Monitoring [] Yes No Locations: Copies of All Reports and Data Requested pjs

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes Q No No Visible/Fine Layer 34 to? >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' >1' West N/A Yes ❑ No No Visible/Fine Layer 34 to 1' > 1' Facade Description: n d

Root Debris: No Visible /l=ine Layer .❑ % to 1" ❑ a? Description:

Setbacks N/A16 Floor __ . Debris: No Visible/Fine Layer % to 1' > 1" Floor:____ Debris: No Visible/Fine Layer 44 to? a 1' Floor:___ Debris: No Visible/Fine Layer % to? a? Floor___ . Debris: No Visible/Fine Layer % to 1' a? Floor.___ Debris: No Visible/Fine Layer 34 to? >1' Com te

Date: Inspection Team: Name: - T Agency: Name: Agency.

NYC-WTC 000129169