WTC debris inspection form, 143 Fulton Street, undated

NYC 9/11 Public Portal Document

WTC Visual Surv® Form:'„ Premise Address: *

Block: Residential 0 ruIior SL Commercial S

I and of BuHgI Lot: Mix Use . Other 4 d~ # of Stories: . AKA's: Building Owner/Management: Telephone Number ( • ). Name: • FAX: Address: On Site Contact: _ Name: Telephone Number: r Building Owner Management Activities Interior Survey Performed ❑ Yesj No Exterior Survey Performed ❑ YesJ No I General Clean Up Ryes ❑ No Locations: ACM Clean Up ❑ YesJNo Locations: Air Monitoring ❑ Yes 4Jo Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" South ❑ N/A Dyes ❑•No .2KNo Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A 1 Yes ❑ No ❑ No Visible/Fine Layer ❑ V2 to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Facade Description:

Roof

Debris: D No Visible /Fine Layer tot" ❑>1" Description:

Setbacks N/A Floor. Debris: ❑ No Visible/Fine Layer 0 to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 0 V to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑V to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments Lam) )e (.LA,

Date: I/ /2002 Inspection by: Name: L z- L.. Agency: Name: Agency:

NYC-WTC 000128076