Visual survey form for 182 Duane Street exterior inspection

NYC 9/11 Public Portal Document vv is.. v15ua1 5urvev rorm l f') l ) I S '_) -, Premise Address: L- - dock: Residentiat Commercial Name of Build S: Lot Mix Use Other . # of Stories: V AKA's: Building Owner/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 a No General Clean Up Yes No Locations: ACM Clean Up L] Yes No Locations: Air Monitoring L] Yesr] No Locations: Copies of All Reports and Data Requested Yes Visual tnsDection Results: Facade: n cted Deb North NIA es No isible/Fine ' 4 to1' > 1' South NIA Yes No No Visible/Fine Layer % to 1 > 1' East N/A Yes No No Visible/Fine Layer to? s 1' West NIA i Yes No No Visible/Fine Layer LayerH%tol, 91' Facade Description:

Roof -

Debris: -- ''No Visible IFine Layer I] % to V . I] > 1'

Setbacks WA9 Floor.__ Debris: No Visible/Fine Layer % to 1' >1' Floors Debris: No Visible/Fine Layer % to1' >1' Floor! Debris: No Visible/Fine Layer % to 1' > 1' Floor__ Debris: No Visible/Fine Layer %to 1' s 1' Floor__ Debris: No Visible/Fine Layer %to1' a 1' Comments _

Date: __J 1nspec ion Team: Name: Agency: N ~, Flame: Agency

NYC-WTC 000130725