NYC 9/11 Public Portal Document
I H I ■»
DEPARTMENT OF ENVIRONMENTAL PROTECTION
EXECUTIVE OFHCES
59:17 JUNCnOX BLVD., 19TH FLOOR, CORONA, NEW YORK 11368-5107
JOEL A'f MIELE, SR., P.E., cojzvssionzr
NYC PEP (BANHM) ASBESTOS C La»D CX3NTROI. PROgRAH
OVERTIME AtTTHORIZATION FORM
Burean/Untt: • ■ Location:
Distribution tfi Week Ending: /s ,
Weekly Attendance
S M T , W TH F S
“T -7 y
NORhULWORK ttXEK ■ ■HOURS
Em^Wvcs Name: CtVIL Service Title: Social Securtt^ 7
total overtime 5% annual salary tn has employee exceeded 5%.
J
retirement eligibility
months hours———— in O.T. ? (yes / no)-------- • month year
—— hours
M?QuUa2
Date(s) Location(s) Reason(s)
comp comp pay comp
str. prem. str. pre. hot.
Report Totals
j Explanatio»U222Si^2C^:,itt:«i£sp^<ficl<i^jth^xasofl|ivfiY3tinx2e^^
Authorized & Approval Si«naturc(s)
Bureau Chicf/Commissioncr’s Designee “Approved Disapproved Date
NYC-WTC_000158981
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