CN-370000-HW682-HW016A.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. 8/26/2020

STATE OF FLORIDA

DEPARTMENT OF ENVIRONMENTAL PROTECTION

Task Assignment This Task Assignment (TA) is entered into between the Parties named below, pursuant to Contract Number: .

1. TA Number: TA Completion Date:

TA Description:

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

Department Project Manager: Department 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 Location(s):

Project Name:

4. As consideration for the services rendered by Contractor under the terms of this TA, the Department shall pay the Contractor on the following bases, up to the Total TA Value as indicated below:

Fixed Price:

Fixed Unit Rate: (Extended Price)

Cost Reimbursement:

Total TA Value:

5. The Parties agree to comply with the terms and conditions of the underlying the Contract, and the following attachments which are hereby incorporated by reference:

Attachment 1:

Additional Attachments (if necessary):

IN WITNESS WHEREOF, this TA 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.

HW682

HW016A Completion December 30, 2023

This Task Assignment authorizes ECT to perform PFAS screening at 8 sites in accordance with the attached Scope of Work.

Ginger Shirah 850-245-8899 Contractor Environmental Consulting and Technology, Inc. (ECT) Contractor

Contractor Mark A. Culbreth Contractor 813-289-9338 Multiple

Multiple

PFAS Screening

Contractor Contractor

✔ $ 27,200.00

$ 27,200.00

Scope of Work

Environmental Consulting and Technology, Inc. (ECT Contractor Mark A. Culbreth

Contract Manager

Kelly Crain Digitally signed by Kelly Crain Date: 2023.04.12 10:28:55 -04'00'

N/A

04/12/2023

Digitally signed by Mark Culbreth Date: 2023.04.12 14:11:48-04'00'Mark Culbreth

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WC TAFORM

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for each well sampled, field notes/forms, and the certified lab report for Fashion Square Cleaners, Jolie Cleaners, Victorian Cleaners, 08/30/2023

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for Bolton Plaza and Miller Machinery & Supply 07/30/2023

Email or letter report summary including one figure showing PFOA, PFOS, and PFOA+PFOS concentrations for Aldos Cleaners and Southside Cleaners 10/30/2023

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Fashion Square Cleaners, Jolie Cleaners, Victorian Cleaners, and Super Cleaners

$ 13,600.00

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Bolton Plaza and Miller Machinery & Supply $ 6,800.00

Upon Submittal of PFAS Deliverable, IDW Disposal Documentation and project management for Aldos Cleaners and Southside Cleaners $ 6,800.00

$ 27,200.00

HW682

HW016A

1. Contractors should:

a. Review each site and select up to 5 monitoring wells (MWs) to sample

i. MWs should be selected from source and downgradient areas that have the greatest potential to reflect PFAS impacts

ii. Offsite MWs should be avoided, and should only be selected if the site conditions or conceptual site model warrant them

iii. Proposed MWs should be:

1. Accompanied by a recent groundwater plume map and flow direction map

2. Approved by Breck Dalton

iv. Sample analysis should be through the DEP Lab (zero cost). Shipping of kits to the contractor and return shipping of samples to the lab are absorbed by the DEP Lab (a paid FedEx shipping label will be included with each kit)

v. The deliverable should be a simple email or letter report summary including one figure with text boxes (showing PFOA, PFOS, and PFOA+PFOS concentrations for each well sampled), field notes/forms, and the “certified” lab report (certified meaning that the lab report is final and not draft).

Isoconcentration/extent lines are not required on figures but can be included if the data support them.

b. Submit the deliverable within 2 working days of receipt of the certified lab report, if concentrations exceed the PGCTL of 70 ng/l in any single well from the site.

c. Copy Kelly Crain, Aaron Cohen, Jen Farrell, Doris Brown, and Breck Dalton on the email deliverable.

2. Sites included this TA:

Site Name ERIC ID

ALDOS CLEANERS 5188

BOLTON PLAZA 4269

FASHION SQUARE CLEANERS 4742

JOLIE CLEANERS & LAUNDRY 4763

MILLER MACHINERY & SUPPLY CO 4589

SOUTHSIDE CLEANERS-LAUNDERERS 5376

SUPER CLEANERS INC 4390

VICTORIAN CLEANERS 4775