1,-J:o..s Lf 3l./ /..J, 135 '5 1 04 ? .'ex; ~'~lJ ~-'35 1-c: o j;I /; '/)5 b:3L.J ((/ '.35 1.'D-1. 1~0<., 123LJ 7 };,:5 (b}(6 ); (b)(7)(Cj SIGNATUKF. (b)(6 ); (b}(7)(C) MCCNRW YORK SPECIAL HOUSING UNIT 30 MINUTE CHECK SHEET ZA TIER-K DATE: 07/22/2019 -------- TIME FRAME TIME TIME I SIG