67 MURRAY ST 1001419, 132/2

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: -j Block: Residential ❑ Commercial I I Name of Building: Lot: Mix Use ❑ Other ❑ # of Stories: ç AKA's: Building OwnerlManagement Telephone Number: ( ) Name: FAX: ( ) Address: On Site Contact: Name: ' 'Telephone Number: ( ) Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ 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 ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to1" 0>1" South ❑ N/A ❑ No ❑ No Visible/Fine Layer Q%to1" 0>1" 0>1" [a -Yes

East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Y2to 1" West ❑ N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑Y2to1" 0>1" Facade Description: 4-.

I Roof Debris: 0 No Visible /Fine Layer 0>1" Description: _tia

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ V2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %2 to 1" ❑ > 1"

Comments

/2002 Inspection Team: Name: Agency: Date: i)I / e. Agency: Name:

NYC-WTC 000100505