77 MURRAY ST 1001423, 132/7

NYC 9/11 Public Portal Document

WTC Visual Survey Form

Mix Use ❑ Other ❑ S~+3 (cc ci I Wt tp l Lot: # of Stories: Building Ow Name: I` FAX: Address: On Site Con Name: -~ Telephone Number. uilding Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up 0 Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes [] No Locations: CODies of All Reports and Data Requested 0 Yes

Visual Inspection Keswts: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" D> 1 ❑ No Vsible/Fine Layer ElY2 to 1" D>1 South ®N/A 0 Yes ❑ No 0> 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" D>1 West ❑ N/A ❑Yes Facade Description: S Qic- ç-S AZ~ Jt

Roof

Debris: ❑ No \isible /Fine Layer El'/2 to 1" ❑ > 1' Description: ( O'r N `-" wN 4i _ _Il... .A QI J A..ntlAJN

Setbacks N/A ® Floor. Debris: 0 No Visible/Fine Layer ❑ Y2 to 1* ❑ > 1" Floor Debris: 0 No Visible/Fine Layer ❑ Y2 to V ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments fsj ' C

A.

0/ / 1200 Inspection Team: Name: . Agency: Date: Name: N. ~►kiR-4 z r= Agency: 4kW L

NYC-WTC 000099708