Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

Contract Number: HW553

Task Assignment#: DC021A

Deliverables:

Deliverable Site assessment workplan with EDR report & aerial photos with interpretation of data - ST 1

Invoice Schedule:

Requi rements for Invoice Submittal DEP approval of site assessment workplan with EDR report & aerial photos with interpretation of data - ST 1

TOTAL COST

Del iverable Due Date

2-May-16

Amount to be Invoiced

$4,200.00

$4,200.00

BWC TAFORM 2/03

Site Assessment Work Plan Development Task List

Site Data Review:

Application Site Screening Report Department of Health well survey and sampling data Rapid Risk Screening Form County Comprehensive Plan for identification future land use

- Additional information as available (e.g. Oculus, Google maps, aerial photographs, soil surveys, topographical maps, building/planning department records, land use maps, insurance maps, other regulatory agency records, etc.)

Drycleaning Site Visit:

Complete Drycleaning Site Visit Checklist Verify Site Screening Report information and Rapid Risk Screening Information Confirm location/contamination data for ranking drinking water well for program eligibility Identify above/below ground utilities and potential impediments to assessment activities Identify land use of adjacent properties Identify nearby properties that may require site access Verify accuracy of site map, revise as necessary Identify area lithology I hydrogeologic characteristics Discuss work plan elements with property owner and get direction regarding approach to tenants, and schedule.

· Deliverables:

Completed Drycleaning Site Visit Checklist

Site Summary Report - brief summary of site with attached figure(s) Figures should identify major features i.e., facility, ranking well, waste storage areas, utilities, etc.

City/County Plat Map identifying all parcel identification numbers, zoning classifications, and current property use for properties within 1,000 feet of the site.

Summary of historical data ._ results of the historical data review, and site inspection.

Overall project approach summary (<1 pg) i.e. proposed order in which work should proceed on the assigned sites following evaluation of the preliminary site assessments and other logistical considerations.)

Sampling Plan - Including recommendations for soil, soil gas, MAGs, groundwater, sediment and surface water sampling (as appropriate). Including QA/QC measures, screening levels, and sampling procedures (SOP) including site map indicating proposed/alternative sampling locations Identify property owners (name and address) for all properties adjacent to the site and for those properties on which sampling is proposed and site access will be required

Health and Safety Plan in compliance with 29 CFR 1910.120 Proposed resource-loaded schedule for Site Assessment with projected schedule for

Site Remediation

Cost Estimate/Level of Effort (LOE) Worksheets, including subcontractor quotes, as appropriate. The Cost Estimate/Level of Effort should be submitted under separate cover to the DEP Project Manager.