NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
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S947 JUNCnaV 3LVD., 19TH IWOR, CORO.KA, SEW YORK 11365-5107
JOEL A. MULE, SR., P.E., cOMxasstONza
KYC DE? CBAHHH) ASBESTOS C LEAD CONTROL PROGRAM
OVERIIMS ACTHORIZAIXON FORM
Bureau/Unit: ' Location: c.
Dbtribution #: Week Ending; S> yz> eS^ I
Weekly ARendance
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NORAWL WORK «XEK —----- HOURS
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total o%*ertlne : -. 5% annual saiary.ln ■■ has employes exceeded 5%. . '
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rctinment eligibility » • « - r-'
pm'ious 12 months . ■ hours ' • In'O.T. 7 (yes / no) — month jreer . •;. •'
— hours
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Supervisor Date >/
Bureau ChieffCorami^iofiePs Dcsij Approved Q Disagproved
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