WTC facade inspection form, 106 Fulton Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form 10.0t u as Premise Address: OCn - -roof S-race-r Block: '?S Residential 0 Commercial J J Name of Building: Lot: ao Mix Use 0 Other # of Stories: ' AKA's: W Building Owner/Management Telephone Number. Name: `iA e u w i v orrt-e rr 1 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 0 No Locations: ACM Clean Up Yes ❑ No Locations: Air Monitoring f Yes j] No Locations: Copies of All Reports and Data Requested j J Yes

Visual Insuection Results: Facade: Inspected Debris North South East ❑ N/A ❑ N/A ❑ NIA ❑ Yes No DYesDNo DYesDNo No Visible/Fine Layer E] Y to 1" No Visible/Fine Layer ❑%to 1" No Vsible/Fine Layer ❑Mato 1" H]> 0>1' >i" 1"

West ❑ N/A ❑ YesD No No Visible/Fine Layer []34to1" 0>1" Facade Description:

Roof Debris: No Visible /Fine Layer . tJ>1" D14to1 Description:

Setbacks N/AD Floor. Debris: ❑ No Visible/Fine Layer 014 to 1" 0>1' Floor. Debris: t] No Visible/Fine Layer % to 1" >1' Floor. Debris: t3 No Visible/Fine Layer % to 1" B6. 1" Floor. Floor Debris: 0 No Visible/Fine Layer ❑ 14 to 1" Debris: 0 No Visible/Fine Layer ❑ % to V Bo> 1" 1" Comments

Date: S /2/200 Inspection Team ame: _ - N-t2ou. 10 s Agency: -'ICDC9 Name: Agency:

NYC-WTC 000128686