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Document / 2 pages

WTC inspection form, 40 Fulton Street area, Oct 2001

Machine-extracted title · confidence 90%

Inspection form recording facade and ACM status for the specified block.

NYC-WTC_000129206–000129207

Folder label: “40 FULTON STREET 1075618, 75/21

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Scanned page image, NYC-WTC_000129207
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NYC 9/11 Public Portal Document

WTG Visual Survey Form C.LEAt4 Premise Address: 4o FuL1DN STe -r Block: -is Residential jJ Commercial L J Name of Building: Lot: a' Mix UseD Other # of Stories: z AKA's: Building Owner/Management 40 u --rte M u.e Telephone Number. (2 0z) 26' - 8 r Name: m t~ W'r L c 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: ROOF s ces A*3D .og S0e~ess ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes[] No Locations: Copies of All Reports and Data Requested J Yes

Visual-inspection Results: Facade: inspected Debris North ❑N/A ®Yes❑No ® No Visible/Fine Layer ❑Yto1" 0>1". South ❑ N/A ® Yes ❑ No No Visible/Fine Layer ❑%to1" 0>1" East ❑ NIA ® Yes ❑ No No Visible/Fine Layer ❑Vato 1" 0>1" West ❑ N/A Yes ❑ No ® No Visible/Fine Layer 0Y2 to 1" 0>1" Facade Description:

Roof

Debris: ® No Visible /Fine Layer ❑ % to 1" ' ' ❑ > 1" Description: sQ w-m. E rz Is o1E~SGeJEU

Setbacks N/A ❑ Floor 2G' Debris: ® No Visible/Fine Layer ❑'/ to 1" 0>1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: 0 No Visible/Fine Layer 0 %a to 1" 0>1" Floor. Debris: 0 No Visible/Fine Layer 0 % to V 0>1" Floor: Debris: ❑ No Visible/Fine Layer ❑ h to 1" 0>1" Comments

Date: _off / 1 /2002 inspection Team: Name: ` DA / Ao2o Agency: YC vEP Name: _Agency:

NYC-WTC 000129207

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NYC-WTC_000129207Source: NYC Law Department, mirrored locally

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