Visual survey form, 111 Fulton Street, Feb 2002

NYC 9/11 Public Portal Document vIc visual survey corm Premise Address: III Fuerot STR---ET Block: Residential D Commercial Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: isi DIWAm STREET 44.,.c 60 Ae SST Building Owner/Management 224 W 30 LL. u8A Telephone Number. (z-. )*2q -- 9690 Name: t s i w r u (Rm ii.C. FAX: 207 Address: i u r-or~N sr NY N y On Site Contact: = Name: * USA4+ floNouuE becE a Esc wiLtot"sT Telephone Number 2r2 924-%90 rwr 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 0 Yes ❑ No Locations: Copies of All Reports and Data Requested j j Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A Yes ❑ No No Visible/Fine Layer ❑'h to 1' 0>1" South ❑ N/A JYesDNo No Visible/Fine Layer D34to1' 0>1" East N/A JYesDNo No Visible/Fine Layer ❑Y:to 1" 0>1" West 1 N/A ❑ Yes ❑ No No ViSible/Fine Layer ❑34 to 1" 0>1" Facade Description: t NEE (AN+~1 aN O itappWS C LoWE1z. FL—

Roof

Debris: Description: ❑ No Visible /Fine Layer W %to 1" '' " 0>1"

M Yi ie LocAr D 'RGI.1E.TU -r S't't*

Setbacks N/A m Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ Ys to 1" ❑ > 1' Floor. Debris: No Visible/Fine Layer ❑ % to 1' > 1" Floor____ Debris: n No Visible/Fine Layer ❑'/ to 1" > 1' Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1' > 1'

Comments

Date: 07 / 12 002 Inspection Team: Name: TDA /ftc02v Agency: 1~YC Name: Agency:

NYC-WTC 000128764