WTC Visual Survey Form 3f44* 1001207
Premise Address: i0 0 F U I+ O
I ree-~
Block: IS ResidentialD Commercial Name of Building:
Lot: 4 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 ❑ No
Exterior Survey Performed ❑ Yes ❑ No
General Clean Up ❑ Yes ❑ No Locations:
ACM Clean Up ❑ Yes ❑ No Locations:
Air Monitoring ❑ Yes ❑ No Locations:
Copies of All Reports and Data Requested Yes
visual Insoection Results:
Facade:
Inspected Debris
North ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" [J>1"
South ❑ N/A ❑ Yes ❑ No ❑ No ViSible/Fine Layer % to 1" 0>1"
East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Y to 1" 0>1"
West ❑ N/A ❑Yes 0 No ❑ No Visible/Fine Layer IA to 1" ❑ > 1"
Facade Description:
Roof
Debris: ❑ No Visible /Fine Layer z to 1" ❑ > 1"
Description:
Setbacks N/A ❑
Floor Debris: ❑ No Visible/Fine Layer ❑ Va to 1" ❑ > 1"
Floor. Debris: ❑ No ViSible/Fine Layer ❑ 34 to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"
Floor. Debris: ❑ No Visible/Fine Layer ❑'/to 1" ❑ > 1"
Comments
Date: cV /1_/2002 Inspection by: Name: _ {\ P Agency: EP
Name: Agency:
NYC-WTC 000128957
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000128957Source: NYC Law Department, mirrored locally
License agreement between the City of New York and 120 [name] LLC regarding the removal of foreign material from building exteriors at 120 Fulton Street.
License agreement between the City of New York and 120 [name] LLC regarding the removal of foreign material from building exteriors at 120 Fulton Street.