WTC debris inspection form, 92 Fulton Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 1OOI 1 R® Premise Address: çjt BIock:= Residential Li Commercial 0 Name of Building: Lot: j Mix UseD 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 0 Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes 0 No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Q Yes

visual inspection Kesutlts: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yatol" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑to1" ❑>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑%to 1" 0>1" Facade Description: p ~,rn:,~trws ett

Roof *~ N Debris: ❑ No Visible /Fine Layer ❑ % to 1" 1 ❑ > 1" 1 '"'~ Description:

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer 0 a to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Comments ~ c~ 1C C_Q.. - n vt )C

Date: 3 /x/2002 Inspection Team: Name: Agency: Name: Agency:

NYC-WTC 000127583