WTC facade inspection form, 104 Franklin Street, Oct 2002

NYC 9/11 Public Portal Document

WTC Visual Survey Form /o-1i k) Pre*p a Adi r®a.s: ate—. Block: fl Residentiai. ' èommercialp Name of Building: Lot 4 Mix UseD Otherp AKA's: # of Stories: 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 p Yes

Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑34to 1' 0 30 1 0 South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer ❑ %to 1' 0>1' East West O] N/A N/A Facade Description: fl ❑ Yes ❑ No ❑ Yes ❑ No O ❑ No Visible/Fine Layer O] No Visible/Fine Layer ❑ 34 to 1' 034t01' 0>1' 0>1'

Roof pebris: o Visible /Fine Layer -0 6 to 1' 9>1' Description:

Setbacks N/A Floor: Debris: ❑ No Visible/Fine Layer 93 to 1' Floor: Debris: ❑ No Visible/Fine Layer ❑ i4 to 1' Floor: Debris: ❑ No Visible/Fine Layer ❑'h to 1' Floor____ Debris: 0 No Visible/Fine Layer [] 34 to 1' Floor: Debris: ❑ No Visible/Fine Layer [] 4 to 1' Comments

Date: ' /x/2002 Inspection Team: Name: '- Agency Name: Agency:

NYC-WTC 000130653