WTC exterior inspection form for 122 Fulton Street, 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form Iool.? Premise Address: I 0 Fu 14on c5free- I Block: 7 0 Commercial Residential p Name of Building: Lot: Mix Use J 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 j J Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer qç to 1" ❑ > 1" South ❑ NIA ❑ Yes ❑ No ❑ No Visible/Fine Layer % to 1" ❑ > 1" East ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ %% to 1" 0>1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ % to 1" 0>1" Facade Description:

Roof

Debris: ❑ No Visible /Fine Layer to 1" [3 >1" Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" [3> 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer 034 to 1" ❑ > 1" Floor Debris: ❑ No Visible/Fine Layer ❑'/ to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" 0> 1" Comments

Date: c

J2112002 Inspection by: Name: fIP Agency: DE P Name: Agency:

NYC-WTC 000129003