NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
EXECmVE onticB
SMFJUNCnOX 3LVD.. WTH FLOOR, CORONA, NEW YORK 11368-5107
JOEL A. MIELE, SR., P.E-, commssionsr
HTC DE? (BANEK) ASBESTOS t LEAD CONTROL PROGRAM
OVERTIMS AOTHORIZATION FORM
Bureau/Unit: * ' Location:
Distribution #: Week Ending: 1 lrlo\
Weekly Attendance
s M T w TH F s
to'/2- n - 15
NORAUL WORK WXXK-- ----- HOURS
EsvLorsE Name: Cmi. Scxncs Tmx: SooALSccuiun*#:
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refifemenf aigiBfli^ fiT
toul overtime «.•• • : . S% annual salaryJn 1 has employee exceeded 5%. T.s^e
pre>*ious 12 months . hours imO.T. ? (yes / no) — nonth year
——•hours ____________________
TIME ALL std/bv
DaTe(s) Location(s) ReasoR(s}
comp comp . pay comp .
itn prcpu ttro pre, hot
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Report Totals sr 6
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•Authorized &^pr^alSignaturc(s}
Supcr^Isoi Date 7 / ' -
Approved Q Disanproved
Bureau ChielZComriisponcr’i D^ignec Date
NYC-WTC_000159108
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