67 GREENWICH STREET 1000796, 19/11

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: ~' 2.. ir Block: Residential El Commercial El Name of Building: Lot: Mix Use ❑ Other ❑ 01-x" # of Stories: -. AKA's: W\ C- _ C ik C— Building Owner! anagement: telephone Number: q7_-. ) s-d 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,$ es ❑ No Locations: ACM Clean Up ❑ Yes [lo Locations: Air Monitoring ❑ Yes ! No -- Locations: Copies of All Reports and Data Requested ❑ Yes

Visual Inspection Results: Facade: Inspected Debris North g[LA ❑ Yes ❑ No QNo Visible/Fine Layer ❑'/z to 1" ❑ > I" South ❑ N/A yes ❑ No No Visible/Fine Layer ❑'/2 to 1" 2- 1" East ❑ N/A Yes ❑ No No Visible/Fine Layer ❑'/ to I" > 1" West ❑ N/A 1Xes ❑ No No Visible/Fine Layer ❑Y to 1" > 1" Facade Description:

Roof LS Debris: ❑ No Visible /Fine Layer 0 1/2 to 1"•I Description:

Setbacks N/A ❑ Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" n> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/z to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1"

Comments

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•— -S-*7 5 Z --- Date: f I~`- 12002 Inspection Team: Name: (/9)L -t1 C A"A h D& Agency: Name: Agency: J'f NYC-WTC 000128339