254 FRONT STREET Block: 107 Lot: 28 BIN: 1001377 22 DOVER ST

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: u V

Block: ( L Residentlaip Commercial --F c? Name of Building: Lot Mix UseD OtherjJ # of Stories: AKA's: BufldIng9vperIMa gement Telephone Number. ( ) Name: FAX: Address: On Site Contact Name: ' MW{ .~.,...-~.. Tele hone Number. n Building Owner Managemàht Activities Interior Survey Performed Yes No Exterior Survey Performed B Yes No General Clean Up Yes No Locations: ACM Clean Up . U Yes No Locations: Air Monitoring ❑ Yes 9 No Locations: Copies of All Reports and Data Requested D Yes

Visual Insooction Results: Facade: Inspected Debris North N/A Yes ❑ No No Visible/Fine Layer 36 to 1' >1' South N/A Yes No No Visible/Fine Layer ! to 1' >1' East N/A Yes No No Visible/Fine Layer 34 to V >1' West N/A as No No Visible/Fine Layer 34 to 1' 9>1' Facade Description: f ()

Roof Debris: No Visible /Fine Layer 934t01' 9>1' Description•

Setbacks N/A Floor___t Debris: D No Visible/Fine Layer 34 to 1' >1' Floor Debris: No Visible/Fine Layer 36 to 1' >1' Floor____ Debris: No Visible/Fine Layer 34 to 1' >1' Floor____ Debris: No Visible/Fine Layer % to 1' >1' Floor Debris: No Visible/Fine Layer 34 to 1' >1' Comments

Date: ~• / /2102 Inspection Team: Name: Agency:_______ Name: Agency: • -ENTEREC

NYC-WTC 000129186