Visual inspection form for 184 Duane Street facade and setbacks

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: . $4 L Block: Residential Commercial Name of Building: Lot: Mix Use Otherfl # of Stories: 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 0 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 D Yes

Visual Inspection Results: Facade: Inspected Debris North /A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" South A es ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East /A Yes ❑ No ❑ No VSible/Fine Layer ❑ % to 1" Q > 1" West N/A ❑ Yes Q No ❑ No Visible/Fine Layer E)'/2 to 1" 0>1" Facade Description:

Roof

Debris: No Visible /Fine Layer .❑ % to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor. Debris: 0 No Visible/Fine Layer 0 Ya to 1" D>1" Floor. Debris: 0 No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: Q No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer 0 h to 1" ❑ > 1"

Comments

Date: N II / 12002 Inspection Team: Name: (ftcL Agency: Name: Agency:

NYC-WTC 000130737