WTC facade inspection form, 103 Franklin Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form 4) q 9' Premse i Adr,^o": (0 a - Q---- -t- - ,

Block: Residential Commercial9 Name of Building: Lot: $ Mix UseD therD # 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 9 No Locations: ACM Clean Up 0 Yes 0 No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested p Yes

Visual Inscectlon Results: Facade: Inspected Debris North ❑N/A ❑Yes❑No ❑ No Visible/Fine Layer ❑%to1' 0>? ❑ Yes ❑ No South East West ❑ N/A N/A O] N/A ❑ Yes ❑ No JJYesDNo R No Visible/Fine Layer D4toV ❑>1' No Visible/Fine Layer ❑ 6 to 1' ❑ > 1 ❑ No Visible/Fine Layer ❑ i4 to 1' 0.-.I- Facade Description: , fl , n -

Roof

Debris: o Visible !Fine Layer .❑ % to 1' ❑ > 1' Description:

Setbacks N/Ar Floor Debris: Q No Visible/Fine Layer ❑ % to 1' 0>1 Floor:____ ❑ No Visible/Fine Layer a i4 to 1' 0>1 Floor 0 No Visible/Fine Layer '% to 1' ❑ > 1• Fioor:i Debris: ❑ No Visible/Fine Layer g i4 to 1' Floor_ ~— ❑ No Visible/Fine Layer ❑ i4 to 1'

Comments

Date: 1l 412002 Inspection Team: Name: - 1-- Agency: Name: Agency:

NYC-WTC 000130647