Asbestos inspection form, 40 Fulton Street, Oct 2001

NYC 9/11 Public Portal Document

't 101St.1$ WTC Visual Survey Form Premise Address: d Block: Residential 0 Commercial Name of Building: Lot: Mix Use Oqr fl . -' # of Stories: AKA's: ITO • " ' 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 Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No No Visible/Fine Layer ❑ Ya to 1" 0>1" South QJ N/A ®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 U No Visible/Fine Layer ❑ % to 1" ❑ > 1" Facade Descript n:

Roof

Debris: ❑ No Visible /Fine Layer /~ ❑ Vat 1" ❑ > 1" Description: a /yO V L4 y , LJO W' r i

Setbacks N/A ❑ Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ %a to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑'% to 1" ❑ > 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1"

Date: 'f- I . Inspection Team: Name: '- Agency: C bP Name: P. Agency: 1> ANT ERA NYC-WTC 000129208