NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
EXICLTIVE 0n?K2S
59-17 JUNCnOC BLVD., 19TH ROOR, CORO.KA, NEW YORK 11368-5107
JOEL A. MIELE, SR., RE., coMyasoxat
NYC DEF (BANHM) AI IZSTOS C LEAD CONTROL PROGRAM
OVERTIMS AUTHORIZATION FORM
Bureau/Unit: * Location:
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Distribution #: jrbz<* Week Eq ding:
Weekly Attendance
S M T W TH F S ?
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NORSML WORK WXEK .. Xi ■HOURS
Emplomx Name: Ont ScRncK Title: Social Securitv#: l
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total overtime u.l/ 5% annual lalaryJn -.v. *. has employee exceeded 5%. retirement eiisibility s •• w > •es%.r
prn-lous 12 months - - hours ———— . j tmO.T. ? (yes / no) - ...... nonth year
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Bureau CbieffComi^^ioaer's O^gnee Approved Q Disapproved
Date * /'£‘'
Date
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NYC-WTC_000159110
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