WTC exterior inspection form, 119 Fulton Street, 2002

NYC 9/11 Public Portal Document 4

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WTC Visual Survey Form $N 100!2.08 Premise Address: 119 t-u - uU r- Block: '78 Residential 0 Commercial J Name of Building: Lot: Mix UseD Other ❑ # of Stories: AKA's: Building Owner/Management Telephone Number ( ) Name: FAX: Address: On Site Contact: Name: Telephone Number ) Building Owner Management Activities Interior Survey Performed [] Yes Q No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes Q No Locations: ACM Clean Up ❑ Yes Q No Locations: Air Monitoring Q Yes Q No Locations: Copies of All Reports and Data Requested I Yes Visual Inspection Results: Facade: Inspected Debris North Q N/A ❑ Yes [] No ❑ No Visible/Fine Layer / to 1" 0>1" South Q N/A ❑ Yes Q No ❑ No Visible/Fine Layer 'Y to 1" 0>1" East ❑ N/A E]Yes ❑ No ❑ No Visible/Fine Layer Y to 1" 0>1" West ❑ N/A ❑ Yes Q No [] No Visible/Fine Layer =/ to 1" 0>1" Facade Description:

Roof

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

Setbacks N/A ❑ Floor Debris: Q No Visible/Fine Layer Q'/2 to 1" 0> 1" .Y Floor. Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1" Floor. Debris: Q No Visible/Fine Layer Q'/ to 1" ❑ > 1" Floor. Debris: Q No Visible/Fine Layer Q'/ to 1" ❑ > 1" Floor Debris: Q No Visible/Fine Layer Q % to 1" 0> 1" Comments

Date: C21 /2002 Inspection by: Name: a P Agency: PtP Name: Agency:

NYC-WTC 000128916