19. (Recommended by Chief Administrative Officer) (Approved by General Manager and Chief Engineer) Approval of Amendment No. 1 to Agreement No. 47459 for Mobile Occupational Health Medical Surveillance Program with Industrial Hearing & Pulmonary Management, Inc. dba Western Health. The Amendment will extend the term by one year and increase the amount by $600,000. Determine item is exempt pursuant to CEQA Guidelines Section 15060(c)(2).