DEP Contract No. GC122, Page 1 of 4

TASK ASSIGNMENT NOTIFICATION FORM

DEP Agreement Number: GC122 Task Assignment #: 1

Program Name: NorthStar Contracting Group, Inc.

DEP Contract Manager: Janice Porto Phone #: (850) 245-8903

Task Description: (use additional pages if necessary)

See Attachment 3 of the Contract GC122

Deliverables:

Deliverable 1: July Summary Report

Deliverable 2: August Summary Report

Deliverable 3: September Summary Report

Deliverable 4: October Summary Report

Deliverable 5: November Summary Report

Deliverable 6: December Summary Report

Deliverable 7: January Summary Report

Deliverable 8: February Summary Report

Deliverable 9: March Summary Report

Deliverable 10: April Summary Report

Deliverable 11: May Summary Report

Deliverable 12: June Summary Report

Due Date: August 17, 2020

Due Date: September 15, 2020

Due Date: October 15, 2020

Due Date: November 16, 2020

Due Date: December 15, 2020

Due Date: January 15, 2021

Due Date: February 15, 2021

Due Date: March 15, 2021

Due Date: April 15, 2021

Due Date: May 17, 2021

Due Date: June 15, 2021

Due Date: July 7, 2021

Task Assignment Type

Fixed Cost: Task Performance Period: July 25, 2020 to June 30, 2021

Total Task Assignment Value:

Amount not to Exceed

$6,501,296.00

$6,501,296.00

Organization Code E.O. Object Code Module Category Fiscal Year GAA Line Item # Budget Representative Approval

450404555 JG 131545 4713 087889 2020-

DEP Contract Manager Date

Cost Center Administrator Date

Program Administrator Date

Division Director Date

Deputy Secretary Date

Secretary Date

Contractor Representative Date

Janice Porto Digitally signed by Janice Porto Date: 2020.07.17 13:01:19 -04'00'

Susan Fields Digitally signed by Susan Fields Date: 2020.07.17 13:08:10 -04'00'

Natasha Lampkin Digitally signed by Natasha Lampkin Date: 2020.07.17 15:19:16 -04'00'

Tim J. Bahr Digitally signed by Tim J. Bahr Date: 2020.07.17 17:52:05 -04'00'

John Truitt Digitally signed by John Truitt Date: 2020.07.20 08:57:50 -04'00'

Justin Wolfe Digitally signed by Justin Wolfe Date: 2020.07.20 10:11:30 -04'00'

Graham M. Witt Digitally signed by Graham M. Witt Date: 2020.07.16 15:00:58 -04'00'

Monica J.

Brady

Digitally signed by Monica J.

Brady Date: 2020.07.16 10:10:28 -04'00'

DEP Contract No. GC122, Page 2 of 4

Task Assignment No. 1 (07/25/2020 – 06/30/2021)

A. Tasks

Contractor performs all work as specified in Attachment 3 of the Contract GC122.

B. Summary Report

The summary report will consist of the following (completed) attachments:

Monthly Status Report (Exhibit A)

Consolidated Time Sheet (Exhibit B)

Individual Time Sheets (Exhibit C)

Monthly Inspection Report (Exhibit D)

C. Performance Measures

Department Contract Manager shall review deliverable documentation to ensure that work has been performed as specified in the Scope. The Department Contract Manager will notify the Contractor of acceptance or any deficiencies in the work and/or deliverables. The Contractor will be given an opportunity to remedy deficiencies at no additional cost to the Department. In addition, the Department Contract Manager will analyze performance on a monthly basis to determine retainage release, per Section D, below.

D. Compensation

Staff hourly rates include all expenses associated with vehicle operation and maintenance, lease, or rental (including vehicle maintenance cost for field visits and operation and maintenance (O&M) inspections; all travel costs associated with Department training and/or meetings with Department representative(s) within Florida) all costs for staffing, including salaries, fringe benefits, rent, utilities, any overhead and indirect expenses; general administrative expenses and all other costs related to the performance of the work specified in the Attachment 3 of the Contract and this Task

Assignment.

1. Performance Incentives

a. In order to encourage more efficient site cleanup, and in addition to the fixed cost payments, the Contractor shall be paid an additional target payment of $500.00, when the following is completed at a site:

A Site Rehabilitation Completion Order (SRCO) per Chapter 62-780.680, F.A.C., or Low Scored Site Initiative

No Further Action (LFNA) is issued, but only if the order is submitted to the Department within 60 days of the approval of the no further action proposal or well abandonment report, whichever is later. The number of discharges listed in a SRCO/LFNA should correspond with the number of discharges listed in the no further action proposal. For example, if multiple discharges were proposed for no further action in a report, only one

SRCO/LFNA shall be submitted.

b. PERFORMANCE INCENTIVE PAYMENT MAXIMUM -The maximum amount that can be paid annually is

$50,000.00 even if more performance incentives are met. Performance incentives must be billed for on the invoice for the month they are achieved.

2. Cost reimbursement: No cost reimbursement will be made under this Task Assignment

DEP Contract No. GC122, Page 3 of 4

E. Financial Consequences

No payment will be made for unsatisfactory work. In addition, six percent (6%) of the monthly invoice will be based on the level to which performance measures are met, up to six percent (6%) of the invoice amount will be withheld as retainage. Quarterly invoices total will be released the month after the last of the quarter’s monthly invoices are submitted (September, December, March, June invoices). Performance for purposes of obtaining the six percent (6%) is based on the following six (6) performance measures:

i. Performance Measure 1: Turnaround Times for Deliverable Reviews – monthly percentage of deliverable reviews that met turnaround times as reported in Storage Tank Contamination Monitoring database

(STCM); and, percentage of deliverable reviews completed by contracted staff including contracted staff that are assigned to DEP offices. A percentage of the reported turnaround times will be verified by the

Department. The monthly percentage will be averaged per quarter.

ii. Performance Measure 2: Purchase Order (PO) Turnaround Times - monthly average of days between staff, managing sites, starting the Schedule of Pay Item (SPI) and the PO issued, as reported in STCM.

The monthly percentage will be averaged per quarter.

iii. Performance Measure 3: Contractor Performance Evaluation (CPE) Completion Rates – the monthly percentage of CPEs as reported in STCM that have not been completed but a final invoice was paid on or after January 1, 2017, and more than 30 days from the date of the contractor invoice submittal.

The monthly percentage will be averaged per quarter.

iv. Performance Measure 4: Inspection Rate – a minimum inspection rate of thirty-five (35) inspections per month is met each month of the quarter.

v. Performance Measure 5: OCULUS Insertions – monthly average of documents that are correctly inserted into OCULUS within fifteen (15) calendar days of receipt or generation, as reported in

Attachment L of the Contract. A percentage of those will be verified by the department. The monthly percentage will be averaged per quarter.

vi. Performance Measure 6: STCM Updates – data entry correctly completed in the STCM database within fifteen (15) calendar days of receipt of information, approval of a document by Contractor, or due date extension, as reported in Attachment L of the contract (Exhibit B). A percentage of those will be verified by the department. The monthly percentage will be averaged per quarter.

2. Performance Measures: Monthly Retainage Release Schedule

The percentage calculated for each of the above six performance metrics will be used quarterly to determine how much retainage will be released, not to exceed 100.0% of retainage withheld.

i. Performance Measure 1 – if the quarterly average is 95.0% or above, then retainage held that quarter will be released. If the quarterly average is below 95.0%, then the 1.0% retainage withheld for each of the three months of that quarter will be forfeited.

DEP Contract No. GC122, Page 4 of 4

ii. Performance Measure 2 – if the quarterly average is 30.0 days or less, then then retainage held that quarter will be released. If the quarterly average is below 30.0 days, then the 1.0% retainage withheld for each of the three months of that quarter will be forfeited.

iii. Performance Measure 3 – if quarterly average percentage is 90.0% or above, then retainage held that quarter will be released. If the quarterly average is below 90.0%, then the 1.0% retainage withheld for each of the three months of that quarter will be forfeited.

iv. Performance Measure 4 – if minimum inspections rate of 35 inspections per month is met in the quarter, then retainage held that quarter will be released. If the inspections per month rate is less than 35, then the 1.0% retainage withheld for each of the three months of that quarter will be forfeited.

v. Performance Measure 5 - if the quarterly average is 95.0% or above, then retainage held that quarter will be released. If the quarterly average is below 95.0%, then the 1.0% retainage withheld for each of the three months of that quarter will be forfeited.

vi. Performance Measure 6 - if the quarterly average is 95.0% or above, then retainage held that quarter will be released. If the quarterly average is below 95.0%, then the 1.0% retainage withheld for each of the three months of that quarter will be forfeited.

EXHIBIT A

Monthly Status Report

I. Please provide a monthly update on the following topics:

A. Number of source properties assigned to each site manager (list by site manager and site category)

B. Number of Purchase Orders issued for Program (LSA/Springshed/Funded/Non-LSSI) sites

a. Current Month

C. Number of Work Orders and Purchase Orders issued for Low-Scored Site Initiative (LSSI)

b. Fiscal Year to Date by Category:

i. Site Assessment

ii. Limited Remediation

D. Number of Closure Orders submitted to DEP categorized by Type (SRCO/SRCOC/LSSI NFA), Date Submitted to DEP, Date Issued, County Code (CC), Facility Identification (FAC ID), Site

Name, and Site Score

II. Please provide information as it applies:

A. Staffing updates to include staff separations, any vacancies that remain open, promotions, or new hires

B. Any comments or explanations the Contracted Team would like to provide regarding deliverable reviews or invoices for which the turnaround time (TAT) was not met.

C. Updates for special projects, if applicable

D. Any other contract-related updates the Contracted Team would like to notify the Department

E. Continue using current TAT document. Update daily and submit monthly.

TEAM 5

Incentives July August September October November

Working Days in Month --> 5 21 21 22 19

Hourly Rate

Contract Manager 120.00$ 4,800.00$ 20,160.00$ 20,160.00$ 21,120.00$ 18,240.00$

Professional Engineer II 98.00$ 3,920.00$ 16,464.00$ 16,464.00$ 17,248.00$ 14,896.00$

Professional Engineer II 98.00$ 3,920.00$ 16,464.00$ 16,464.00$ 17,248.00$ 14,896.00$

Professional Engineer II 95.00$ 3,800.00$ 15,960.00$ 15,960.00$ 16,720.00$ 14,440.00$

Professional Engineer I 97.00$ 3,880.00$ 16,296.00$ 16,296.00$ 17,072.00$ 14,744.00$

Professional Engineer I 97.00$ 3,880.00$ 16,296.00$ 16,296.00$ 17,072.00$ 14,744.00$

Upper Level Eviron.Specialist 95.00$ 3,800.00$ 15,960.00$ 15,960.00$ 16,720.00$ 14,440.00$

Upper Level Eviron.Specialist 95.00$ 3,800.00$ 15,960.00$ 15,960.00$ 16,720.00$ 14,440.00$

Professional Geologist II 86.00$ 3,440.00$ 14,448.00$ 14,448.00$ 15,136.00$ 13,072.00$

Professional Geologist II 86.00$ 3,440.00$ 14,448.00$ 14,448.00$ 15,136.00$ 13,072.00$

Professional Geologist II 86.00$ 3,440.00$ 14,448.00$ 14,448.00$ 15,136.00$ 13,072.00$

Professional Geologist II 86.00$ 3,440.00$ 14,448.00$ 14,448.00$ 15,136.00$ 13,072.00$

Professional Geologist I 84.00$ 3,360.00$ 14,112.00$ 14,112.00$ 14,784.00$ 12,768.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Mid-Level Environmental Specialist 75.00$ 3,000.00$ 12,600.00$ 12,600.00$ 13,200.00$ 11,400.00$

Field Inspector 53.00$ 2,120.00$ 8,904.00$ 8,904.00$ 9,328.00$ 8,056.00$

Field Inspector 53.00$ 2,120.00$ 8,904.00$ 8,904.00$ 9,328.00$ 8,056.00$

O&M Inspector 57.00$ 2,280.00$ 9,576.00$ 9,576.00$ 10,032.00$ 8,664.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Porto_J Typewritten Text EXHIBIT B-Consolidated Time Sheet

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Lower Level Environ.Specialist 61.00$ 2,440.00$ 10,248.00$ 10,248.00$ 10,736.00$ 9,272.00$

Admin. Asst. II 50.00$ 2,000.00$ 8,400.00$ 8,400.00$ 8,800.00$ 7,600.00$

Admin. Asst. II 50.00$ 2,000.00$ 8,400.00$ 8,400.00$ 8,800.00$ 7,600.00$

Admin. Asst. I 45.00$ 1,800.00$ 7,560.00$ 7,560.00$ 7,920.00$ 6,840.00$

Upper Level Eviron.Special.-Embed. 90.00$ 3,600.00$ 15,120.00$ 15,120.00$ 15,840.00$ 13,680.00$

Profess. Geologist II - Embed. 83.00$ 3,320.00$ 13,944.00$ 13,944.00$ 14,608.00$ 12,616.00$

Mid-Level Environ.Special.-Embed. 72.00$ 2,880.00$ 12,096.00$ 12,096.00$ 12,672.00$ 10,944.00$

Low.Level Environ.Sp.-Embed. 56.00$ 2,240.00$ 9,408.00$ 9,408.00$ 9,856.00$ 8,512.00$

Low.Level Environ.Sp.-Embed. 56.00$ 2,240.00$ 9,408.00$ 9,408.00$ 9,856.00$ 8,512.00$

Admin. Asst. II-Embed. 47.00$ 1,880.00$ 7,896.00$ 7,896.00$ 8,272.00$ 7,144.00$

Admin. Asst. II-Embed. 47.00$ 1,880.00$ 7,896.00$ 7,896.00$ 8,272.00$ 7,144.00$

INCENTIVES (Max Annual/Inv Monthly) N/A 50,000.00$

50,000.00$ 136,680.00$ 574,056.00$ 574,056.00$ 601,392.00$ 519,384.00$

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EXHIBIT B

December January February March April May June

22 20 19 23 22 20 22

21,120.00$ 19,200.00$ 18,240.00$ 22,080.00$ 21,120.00$ 19,200.00$ 21,120.00$

17,248.00$ 15,680.00$ 14,896.00$ 18,032.00$ 17,248.00$ 15,680.00$ 17,248.00$

17,248.00$ 15,680.00$ 14,896.00$ 18,032.00$ 17,248.00$ 15,680.00$ 17,248.00$

16,720.00$ 15,200.00$ 14,440.00$ 17,480.00$ 16,720.00$ 15,200.00$ 16,720.00$

17,072.00$ 15,520.00$ 14,744.00$ 17,848.00$ 17,072.00$ 15,520.00$ 17,072.00$

17,072.00$ 15,520.00$ 14,744.00$ 17,848.00$ 17,072.00$ 15,520.00$ 17,072.00$

16,720.00$ 15,200.00$ 14,440.00$ 17,480.00$ 16,720.00$ 15,200.00$ 16,720.00$

16,720.00$ 15,200.00$ 14,440.00$ 17,480.00$ 16,720.00$ 15,200.00$ 16,720.00$

15,136.00$ 13,760.00$ 13,072.00$ 15,824.00$ 15,136.00$ 13,760.00$ 15,136.00$

15,136.00$ 13,760.00$ 13,072.00$ 15,824.00$ 15,136.00$ 13,760.00$ 15,136.00$

15,136.00$ 13,760.00$ 13,072.00$ 15,824.00$ 15,136.00$ 13,760.00$ 15,136.00$

15,136.00$ 13,760.00$ 13,072.00$ 15,824.00$ 15,136.00$ 13,760.00$ 15,136.00$

14,784.00$ 13,440.00$ 12,768.00$ 15,456.00$ 14,784.00$ 13,440.00$ 14,784.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

13,200.00$ 12,000.00$ 11,400.00$ 13,800.00$ 13,200.00$ 12,000.00$ 13,200.00$

9,328.00$ 8,480.00$ 8,056.00$ 9,752.00$ 9,328.00$ 8,480.00$ 9,328.00$

9,328.00$ 8,480.00$ 8,056.00$ 9,752.00$ 9,328.00$ 8,480.00$ 9,328.00$

10,032.00$ 9,120.00$ 8,664.00$ 10,488.00$ 10,032.00$ 9,120.00$ 10,032.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

Porto_J

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

10,736.00$ 9,760.00$ 9,272.00$ 11,224.00$ 10,736.00$ 9,760.00$ 10,736.00$

8,800.00$ 8,000.00$ 7,600.00$ 9,200.00$ 8,800.00$ 8,000.00$ 8,800.00$

8,800.00$ 8,000.00$ 7,600.00$ 9,200.00$ 8,800.00$ 8,000.00$ 8,800.00$

7,920.00$ 7,200.00$ 6,840.00$ 8,280.00$ 7,920.00$ 7,200.00$ 7,920.00$

15,840.00$ 14,400.00$ 13,680.00$ 16,560.00$ 15,840.00$ 14,400.00$ 15,840.00$

14,608.00$ 13,280.00$ 12,616.00$ 15,272.00$ 14,608.00$ 13,280.00$ 14,608.00$

12,672.00$ 11,520.00$ 10,944.00$ 13,248.00$ 12,672.00$ 11,520.00$ 12,672.00$

9,856.00$ 8,960.00$ 8,512.00$ 10,304.00$ 9,856.00$ 8,960.00$ 9,856.00$

9,856.00$ 8,960.00$ 8,512.00$ 10,304.00$ 9,856.00$ 8,960.00$ 9,856.00$

8,272.00$ 7,520.00$ 7,144.00$ 8,648.00$ 8,272.00$ 7,520.00$ 8,272.00$

8,272.00$ 7,520.00$ 7,144.00$ 8,648.00$ 8,272.00$ 7,520.00$ 8,272.00$

601,392.00$ 546,720.00$ 519,384.00$ 628,728.00$ 601,392.00$ 546,720.00$ 601,392.00$

6,501,296.00$ Annual Total:

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NAME: Total Hours Allotted Per Person:

POSITION:

FLEX SCHEDULE:

Month/Year

Adjust as needed Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Total Hours 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

1 Procurement Site Management 0.00

2 Procurement Technical Review (PG/PE) 0.00

3 Non-Program Technical Review (PG/PE) 0.00

4 BER Reviews 0.00

5 SRFA Reviews 0.00

6 LSSI Site Management 0.00

7 LSSI Technical Review (PG/PE) 0.00

8 Innovative Technology Reviews 0.00

9 Database - Creation/Maintenance (Non-Site Mgt) 0.00

10 Data Management/Reporting (Non-Site Mgt) 0.00

11 ARRA Support 0.00

12 FDEP Equipment Management 0.00

13 Inspector Oversight/Management 0.00

14 Remediation Equipment Inventory Reconciliation 0.00

15 Field Inspections / Reporting 0.00

16 O&M Inspections / Reporting 0.00

17 Site Visits - for Site Management 0.00

18 Adminstrative-Clerical 0.00

19 DEP Mail Run 0.00

20 Team Management 0.00

21 Contract Management - describe 0.00

22 DEP Support - PRP Contracts Section 0.00

23 DEP Support - PRP Technical Reviews 0.00

24 DEP Support - other - describe 0.00

25 Training - DEP PRP 0.00

26 Leave/Fringe Time 0.00

27 Training - Non-DEP 0.00

28 Non-DEP Support (Contractor-describe) 0.00

TOTAL HOURS WORKED 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

HOURS WORKED-NON DEP RELATED 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

HOURS REPORTED ON GC 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Staff Signature Date

Supervisor's Signature Date

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EXHIBIT C-Individual Timesheet

DATE of

INSPECTION FACILITY ID SITE NAME INSPECTOR

SCHEDULING BASIS (site manager, request, field notification, institutional control, O&M, Other) COMMENTS

INSPECTION REPORT

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EXHIBIT D-Monthly Inspection Report