WTC facade inspection form, 110 Fulton Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: f \ Block: Residential Commercial Name of Building: Lot: Mix Use El Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: dJ FAX: Address: On Site Contact: Name: Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Perppiied ❑ Yes ❑ No General Clean Up7Xes No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes No 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" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑Yatol" 0>1" East ❑ N/A [&es ❑ No o Visible/Fine Layer ❑Yatol" 0>1" West ❑N/A fJYes❑No O No Visible/Fine Layer ❑/atol" 0>1" Facade Description:

Roof

Debris: No Visible /Fine Layer F]Y to 1" 0>1" Description:

Setbacks N/A Floor. II`` Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'/s to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer Va to 1" r] ❑ > 1"

Comments

Date: 3//2002 Inspection Team: Name: Agency: 3)% L* Z Name: Agency: '4 NYC-WTC 000128696