WTC visual inspection form for 141 Fulton Street, undated

NYC 9/11 Public Portal Document

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WTC Visual

Survey Form

Premise Address: I(AL.-rokI Si L Block: Residential 0 Commercia Namj,9ç Bu1Idjjg— Lot: . Mix UseD .Other •- Y # of Stories: . AKA's: €. - 's

Building OwnerlManagement: Telephone Number: ( ) Name: FAX. Address: On Site Contact: Name: ur, No Telephone Number x 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 All Reports and Data Requested Jj Yes o

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to l" 0>1" South ❑ N/A []No []No Visible/Fine Layer / to 1" ❑ > 1" East ❑ N/A Yes [] No ❑ No Visible/Fine Layer U/2 to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ V to l" 0>1" Facade Description:

Roof

Debris: Description: ❑ No Visible /Fine Layer 3XY2to 1" ❑ > 1"

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer 0V to 1" C]> 1" Floor. Debris: ❑ No ViSible/Fine Layer ❑ Y2 to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ / to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ /2 to 1" ❑ > 1" Comments `

Date: -__/>/2002 Inspection by: Name: C_ N ' Agency: Name: Agency:

NYC-WTC 000128033