NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
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S947JUNCnOX3LVD., 19TH FLOOR, CORONA, NEW YORK 11368-5107
JOEL A. MIELE, SR., P.E., coyyjsstosss
NYC PEP (SANKH1 ASBESTOS C LEAP COKTROL PROGRAH
OVERTIHS AOTHORZEATIOy FORM
Bureau/Unit: * ' Location:
Distribution #: g’HTiO Week Ending:
Weekly Attendance
S M T W . TH F S ?
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NORAWt WORK WXXK HOURS
EstFLOVzx Name; SOCWLSECURm-#:
___________________
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total overtime .hi «.•.-• 5% annual saiary.in-v *. has employee exceeded 5%. refirementeligibSl^'s •'«
prrriotts 12 months - ■ hours imO.T. ? (yes / no)------- month year
———hours
aaMEfflCHB std/bv
DaTe(s) Location(s) Reason(s) comp comp . pay comp .
str. prem. str. pre. boL
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Report Totals 5
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Atiihj^zed ^^ov^Signatufc(s)
Supervisor
Bureau ChieffCommls^toner's Oesi^ee Q Approved Qobagproved
Date
NYC-WTC_000158983
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