WTC inspection form for 77 Warren Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: t Block: Residential CommercialD Name of Building: Lot: Mix Use D Other # 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 ❑ 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: In ected De ris North South ❑ N/A ❑ N/A ines ❑ No — -No No Visible/Fine Layer 0'/2 to 1" -No Visible/Fine Layer ❑'/ to 1" ❑ > 1"- ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" Facade Description:

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

E Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer 0 V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑Va to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ V to 1" ❑ > 1" Comments

Date: . / d /2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC-000112833