WTC debris assessment form, 64 Fulton Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form 10011-7(o Premise Address: ,!f - f - T"" S z -r Block: 7 Residential O Commercial O Name of Building: Lot: % Mix Use Other # of Stories: 1 AKA's: Building Owner/Management: kl/ Am /*jcklw 4Telephone Number:. P11 Name: FAX: ------------------------------------------------------------- Address: '&l-7b1v t o On Site Contact: Name: • ' <o Pi si K - 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 Keswts: Facade: Inspected Debris North ❑ N/A Q Yes ❑ No ®'No Visible/Fine Layer 0114t01" O>1" South ❑ N/A ® Yes ❑ No No Visible/Fine Layer ❑ Y2 to 1" ❑ > 1" East ❑ N/A E Yes ❑ No No Visible/Fii a-layer ❑ % to 1" O>1" West ❑ N/A ® Yes ❑ No ,® No VisibleIFine-L- yer ❑ % to 1" O>1" Facade Description:

Roof

Debris: ( 4t iIMe /Fine Layer ❑ % to 1" ❑ > 1" Description:

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

Comments

Date: 2- / / s /2002 Inspection Team: Name: • i+2 # OroH/W Agency: 2P. Name: Agency: V

NYC-WTC 000129318