NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
EXFCXTIVE OmeS
SM7JUNCnOX8LVD., WH FLOOR, COROSA, NEW YORK 11368-5107
JOEL A. KOELEy SR., P.E./ cowsstoxsa
NYC PEP ASBESTOS g LEAD COKTROI. PROGRAM
OVERTIME AOTHORZZATIOW FORM
BEC
Bureau/Ua!t: * ' Location:,
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Dbtnbution #: Week Ending:
Weekly Attendance
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NORAUt.U'OltKWESX 41OURS
; EMr^VEE Name: z CmtS^ncE Title: SoaxL Security#:
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total overtime
rertime_z S% annual salary in - . has employee exceeded. 5
ezcceded.5*it . retirement eU^^
previous 12 mooths hoars ——— is O.T. ?7 (yes / no).
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DaTe(s) Location's) Reason(s) camp comp . pay comp .
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E Report Totals
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Auti^faed SigMtureW
Supervisor 'si Date
Bureau CliteffCommis^ioner's Desiree Q Approved Q Disagproved Date
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