CN-370000-GC904-223BCO3.pdf

Funding Information:

Org. Code E.O. Object Code Budget Entity Appropriation

Category Grant # Project # Year Amount

☐ Additional Funding Information attached on separate page.

Rev. 8/17/2020

STATE OF FLORIDA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

Task Assignment Change Order This Change Order is entered into between the Parties named below and amends the Task Assignment (TA) and any previous TA Change Orders (TACO) as follows:

1. TA Number: TACO Number: Contract Number:

TACO Description:

2. Parties State of Florida Department of Environmental Protection (Department)

Department’s Project Manager: Department’s Project Manager Phone:

Contractor Name: (Contractor ) ntractor’st ’s Project Manager: ontractor’s t’s Project Manager Phone:

3. Project Number:

(If different from TA Number) Project Name:

4. ☐ There are no changes to the TA compensation.

☐ The compensation of the TA is changed to the amounts indicated below:

Amended Price Price Prior to TACO ☐ Fixed Price:

☐ Fixed Unit Rate: (Extended Price)

☐ Cost Reimbursement:

Total TA Value:

5. ☐ There are no changes to the TA Expiration Date.

☐ The TA Completion Date is changed from ______________ to ______________ (a total of ______ days).

6. ☐ There are no changes to the Attachments.

☐ Attachment ___ is replaced with Attachment -____.

7. ☐ No Additional Changes.

☐ Additional Changes:

8. All other terms and conditions of the TA remain in effect. If and to the extent that any inconsistencies may appear between the TA and this TACO, the provisions of this TACO shall control.

IN WITNESS WHEREOF, this TACO shall be effective on the last date signed below.

State of Florida Department of Environmental Protection

CONTRACTOR Department Name:

Title: Secretary or Designee

(Authorized Signature) (Authorized Signature) Date:

☐ Additional signatures attached on separate page.

Geosyntec is submitting this RFC to install 13 soil borings for laboratory sample collection. 2 of the soil borings will be utilized to confirm the previous concentrations at the CS-3-FR and SB-16 boring locations. The lead soil samples from the 4 step out borings from CS-3-FR will be placed on hold pending the results of the resampling of CS-3-FR (12-24") sample. Samples collected from the SB-16-FR will also be placed on hold pending the results of the PAHs (0-12") and arsenic (24-36") results. The PAHs sample from SB-16-FR (0-12") will be analyzed on 3-day TAT. 2 SB-3-FR step out hand auger soil borings will be installed. 1 SB-5-FR step out hand auger soil boring will be installed. 4 SB-22-FR step out hand auger soil borings will be installed. 1 T&D of soil IDW is proposed for the additional soil borings.

Geosytnec is requesting another extension for the deliverable dues in order FDEP to obtain another site access agreement. The original site access agreement was only valid for 10 days.

10/02/2023

GC904-223B 3 GC904

Melissa Brock 850-245-8922 Contractor Contractor

Contractor Contractor

Contractor

Geosyntec Consultants Joe Applegate 850-556-8419

Petroleum Products Corp

✔ $ 56,877.95 $ 49,781.73

$ 56,877.95 $ 49,781.73 Completion

Completion✔ 03/18/2024 05/02/2024 45

✔ B B 1

TACO3 changes Task 2 deliverable due date from 12/15/2023 to 2/22/2024, Task 3 deliverable due date from 1/16/2024 to 3/1/2024, and POS end date from 3/18/2024 to 5/2/2024.

Geosyntec Consultants

Joe Applegate

Project Manager

Jennifer Farrell

450202000 JG 139900 37450300 087889 NA NA 23 $ 56,877.95

Digitally signed by Jennifer Farrell Date: 2023.10.03 08:36:05 -04'00'

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WCP TAFORM 01_18

Contract Number:

Task Assignment #:

Change Order #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

GC904

GC904-223B

$ 56,877.95

Updated HASP

Interim Remedial Report

Waste Manifest

Updated HASP

Waste Manifest

Interim Remedial Report

07/17/2023

02/22/2024

03/01/2024

$ 48,287.75

$ 0.00

$ 8,590.20

Florida Department of Environmental Protection-Division of Waste Management-Petroleum Restoration Program

Request for Change - Authorization for Change in Scope of Work

068732818 Contract #: GC904 PO #: GC904-223B Petroleum Product Corp Contractor: CO #: 3 Brittany.Anding Contractor Phone: CO Type: Regular

(850) 245-8856 FDEP Cost Share %: 100.00% Ref #: 904-223B Brittany.Anding@floridadep.gov

TASK PAY ITEM UNIT OF MEASURE PAY ITEM PRICE UNITS EXTENDED PRICE

2 3-1. Per Round Trip $687.48 1 $ 687.48

2 5-2. Per Boring $211.48 13 $ 2,749.24

2 8-6. Per Sample $36.33 13 $ 472.29

2 9-5. Per Sample $109.61 13 $ 1,424.93

2 9-8. Per Sample $78.67 3 $ 236.01

2 9-8.a. Per Sample $328.37 3 $ 985.11

9-Digit Facility ID #:

Facility Name:

Task Manager Phone:

Task Manager Email:

This is an authorization for the costs associated with the change in quantities of services being provided and/or deliverable due dates. In order for these costs to be paid, these changes must be processed through a change order to the purchase requisition and a revised Purchase Order issued by MFMP prior to initiating work.

DESCRIPTION

Soil, TRPH Fractionation (MADEP-EPH/VPH Method or TPHCWG Direct Method)

Mobilization, Light Duty Vehicle (car or 1/2 ton truck) - ≤ 100 miles each way

Hand Auger Boring ≤ 10 foot total depth

Soil/Sediment Sample Collection

Soil, Polycyclic Aromatic Hydrocarbons (EPA 8270 or EPA 8310)

Soil, Total Recoverable Petroleum Hydrocarbons (FL-PRO)

Description of Change and Justification: Include complete description of who, what, where, when, how and why.

Geosyntec is submitting this RFC to install 13 soil borings for laboratory sample collection. 2 of the soil borings will be utilized to confirm the previous concentrations at the CS-3-FR and SB-16 boring locations. The lead soil samples from the 4 step out borings from CS-3-FR will be placed on hold pending the results of the resampling of CS-3-FR (12-24") sample.

Samples collected from the SB-16-FR will also be placed on hold pending the results of the PAHs (0-12") and arsenic (24-36") results. The PAHs sample from SB-16-FR (0-12") will be analyzed on 3-day TAT. 2 SB-3-FR step out hand auger soil borings will be installed. 1 SB-5-FR step out hand auger soil boring will be installed. 4 SB-22-FR step out hand auger soil borings will be installed. 1 T&D of soil IDW is proposed for the additional soil borings. Geosytnec is requesting another extension for the deliverable dues in order FDEP to obtain another site access agreement. The original site access agreement was only valid for 10 days.

Geosyntec Consultants 850.528.2268Task Manager Name:

Page 1 of 2F&TS Schedule of Pay Items 10-06-22

Florida Department of Environmental Protection-Division of Waste Management-Petroleum Restoration Program

Request for Change - Authorization for Change in Scope of Work

068732818 Contract #: GC904 PO #: GC904-223B Petroleum Product Corp Contractor: CO #: 3

9-Digit Facility ID #:

Facility Name: Geosyntec Consultants

2 9-11. Per Sample $15.47 8 $ 123.76

2 9-14. Per Sample $15.47 8 $ 123.76

2 9-76. Percent Surcharge $0.62 109.61 $ 67.96

3 12-6. Per Drum $225.68 1 $ 225.68

Task Change Order Subtotals

2 6,870.54$ 3 225.68$

Period of Service: 7,096.22$

Total Authorized Cost (FDEP Share: 100%)

Contractor Representative: J. Brooks Baldiwn 9/29/2023 (Print Name) (Date)

FDEP Task Manager: Brittany Anding (Print Name) (Date)

Administrative Reviewer:

(Print Name) (Date)

Reviewer (optional):

Technical Approval (optional):

Cost Center Approval (optional):

Soil, Arsenic (EPA 6010 or EPA 6020)

Soil, Lead (EPA 6010 or EPA 6020)

Additional Laboratory % Surcharge authorized in the ATC contract for 3 Day Turnaround.

Transport and Disposal of Petroleum Impacted Soil (includes drum)

(Signature)

2/22/2024 3/1/2024

Deliverable Name

Interim Remedial Report/Tabulated Spreadsheet Waste Manifest(s)/Photos/Field Notes (if necessary)

*For reimbursable pay items the cost listed is a "not to exceed" amount. Fees will be reimbursed for the pay item based on the actual invoice. Please note, the unit of measure for these items will be displayed as dollars for invoicing purposes. Please refer to the Scope of Work for additional description of these items.

(Signature)

3/18/2024 5/2/2024

Previous End Date New End Date

(Signature)

Previous Due Date New Due Date

12/15/2023 1/16/2024

Page 2 of 2F&TS Schedule of Pay Items 10-06-22

10/2/2023

Florida Department of Environmental Protection - Petroleum Restoration Program

FDEP Facility ID#: 068732818 STCM Facility Name:

Any blank fields are not applicable to the scope of work.

SOIL and AIR SAMPLING TABLE

Task # Soil /Air Sample Locations

Frequency (if applicable)

Expedited Turnaround

(TA)

Depth Interval (if applicable)

(9-5.)

PAHs

(9-8.)

TRPH

(FL-PRO)

(9-8.a.)

TRPH

Fractiona tion

(9-11.)

Arsenic

(9-14.)

Lead

(8-14.)

Encore

Sampler

2 SB-3-FR Stepouts 8 2 SB-5-FR Stepouts 3 3 3 3 3

CS-3-FR 1

resample and 4 stepouts

2 SB-16 1 resample & 1 stepout 3-day TA for 1 PAHs only 2 2

2 SB-22 Stepouts 3 2 Task 2 Subtotal 13 3 3 8 8 0 0 0 0 0 0 0 0 0 0

13 3 3 8 8 0 0 0 0 0 0 0 0 0 0

Petroleum Products

GRAND TOTALS

Attachment A (Soil-Air Sampling) Version 04-15-19

Florida Department of Environmental Protection - Petroleum Restoration Program

FDEP Facility ID#: 068732818 STCM Facility Name:

Any blank fields are not applicable to the scope of work.

SOIL BORING (SB) and WELL INSTALLATION TABLE

TASK # Installation Method Quantity Depth

(ft bls)

Total Boring

Footage (ft)

Screening Depth

Interval 1 & Spacing

Screening Depth

Interval 2 & Spacing

Screening Depth

Interval 3 & Spacing

Quantity Well Type Well

Diameter (in)

Depth (ft bls)

Screen Interval (ft bls)

Total Well

Footage (ft)

Surface Casing

Diameter (in)

Surface Casing Depth

(ft)

Total Casing

Footage (ft)

Well Completion

Type

2 Hand Auger 2 4 8 1' SB-3-FR Step Outs 0 0 2 Hand Auger 1 3 3 1 SB-5-FR Step Outs 0 0 2 Hand Auger 5 2 10 1 CS-3-FR Step Outs 0 0 2 Hand Auger 2 3 6 1 SB-16 Step Outs 0 0 2 Hand Auger 3 4 12 1 SB-22 Step Outs 0 0

39 0 0

Petroleum Products

TOTALS

Screening/Split Spoon IntervalsSOIL BORING DETAILS WELL INSTALLATION DETAILS

Attachment A (SB-Well Installation) Version 04-15-19

FDEP FAC ID-658731630

-FR

-FR

-FR

-FR

-FR

-FR -FR

-FR

-FR

-FR

-FR

-FR

BBaldwin Line

BBaldwin Typewritten Text N

RTemple Stamp

RTemple Line

RTemple Line

RTemple Line

RTemple Line

RTemple Line

RTemple Stamp

RTemple Stamp

RTemple Stamp

RTemple Stamp

RTemple Oval

RTemple Oval

RTemple Oval

RTemple Oval

RTemple Oval

RTemple Oval

RTemple Oval

RTemple Callout Collect each interval to 48" deep.

RTemple Callout Collect each interval to 36" deep - As. Pb, PAHs, and TRPH (SP).

RTemple Callout Collect the 12-24" interval for resample and step outs; hold step-outs

RTemple Oval

RTemple Oval

RTemple Oval

RTemple Callout Angled boring underneath structure.

RTemple Callout Collect:

0-12": BaP 24-36', 36-48": Arsenic

RTemple Callout Sample step-outs only @ 36-48" for arsenic

JApplegate Oval

JApplegate Text Box Step out and hold for resample of CS-3, 12-24"

JApplegate Text Box Resample SB-16 for BaP, 0-12" and for As 24-36"

Pages from RFC#3_AttachmentB-SPI-068732818-TSS-SSA.pdf