NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
EXECbTTVE OraCEJ
59:17 JUNCnOX W.VD.,.19TH FLOOR, CORONA, NEW YORK 11368-5107
JOXLA'f MIELE, SR., P.E., COMXSSIOKSR
NYC PgP (BANHM) ASBESTOS C LBfiP CONTROL PROGRAM
OVERTIME AUTHORIZATION FORM
Bureau/Unit: /$ ' Location:1'7 ^^^<6
Distribution #: j Week Ending:
Weekly Attendance
s M T . w TH F s
s 77a 7'/^ //
NORMAL "'ORK WTEK —nouns
Emplovce Name: C«WL Seruce Tmx: Social SECuam*#:
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total overtime i5% annual salary in has employee exceeded 5%. redrement eligibility
pres-ious 12 months Ihours-..... . —' ■— in O.T. 7 (yes / no) — month -' ■ I year.........
——hours
aoHnBHKSnow atd/bv
Date(s) Location(s) Reason(s)
comp comp pay comp
sir. prem. sir. pre. hoi.
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Report Totals i6 z
Explanation: ?!.Sf.:cifyin (hc3pncebc’'^‘ i..e/ a0»yitiiiat^ploycc:? i-tn;!
Authorized & Approval Signaturc(s)
Ourcau Chicf/Commissioncr's Designee
7
"Approved |~~j Disapproved
Date ,
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Date
,
NYC-WTC_000158973
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