CN-370000-HW686-DC010D.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.

HW686

DC010D September 26, 2025

Proposal for remediation system decommission - Removal of SVE system.

Mary Uribe 850-245-8990 Professional Service Industries, Inc. (Intertek-PSI)

Joshua Newell 863-712-4342

ERIC_5357

511 Haines City Mall Haines City, Polk County

Haines City Quality Cleaners

$ 11,419.35

$ 11,419.35

Scope of Work

Professional Service Industries, Inc. (Intertek-PSI)

Mubeen Darji

Mubeen Darji, P.E. Digitally signed by Mubeen Darji, P.E.

Date: 2025.01.13 11:49:37 -05'00'

N/A

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

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Haines City Quality Cleaners ERIC_5357 SubTask 2 LOE 2 SYSTEM DECOMMISSION

DATE: 10/30/2024

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Geologist, NW Coordinate field efforts with owner/tenant 1

Total 1

Project Engineer, JN Fill out and submit FDEP equipment transfer forms 2

Total 2

Project Scientist, JD Prep for field event 1

Travel (4 hr round trip) 4

Oversight of SVE system decommission 8

Total 13

Staff Scientist, MM Prep for field event 1

Travel (4 hr round trip) 4

Disconnect carbon vessel from system 1

IDW sample collection 1

Pickup and dropoff sample kit at lab 1

Total 8

TOTAL LABOR 24

VEHICLE TYPE RATE UNIT USEAGE

$0.00

Equipment Van / Truck $120.00 day 2 $240.00

TOTAL VEHICLE $240.00

SUBCONTRACTOR COSTS

NAME PURPOSE COST

Action Environmental $2,475.00 $2,475.00

Petrotech SE IDW (carbon) Disposal $165.00 $165.00

TOTAL $2,640.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC

TCLP Metals $135.00 1 $135.00

TCLP Volatile Organics by GC/MS $210.00 1 $135.00 $210.00

TCLP Semi-volatile organics by GC/MS $260.00 1 $260.00

TOTAL LAB $605.00

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

Construction/O&M supplies $75.00 day 2 $150.00

$150.00

Expendables $40.00 day 2 $80.00

TOTAL EQUIPMENT $230.00

Contingent Carbon Disposal Analysis

System decommission, trailer transport, and fence handling

FINAL --7/24/96

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Haines City Quality Cleaners ERIC_5357 SubTask 3 LOE 3 SUMMARY OF ACTIVITIES

DATE: 10/30/2024

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

Senior Engineer, GR Review letter report 2

Project Engineer, JN Letter report generation 20

Technical oversight 2

Total 22

Project Scientist, JD Gather report backup (field logs, disposal manifests, photos) 3

Develop photo log 2

Total 5

GIS/CADD Specialist, DG Generate figures 2

Administrative Assistant, BM Compile documents 2

TOTAL LABOR 33

VEHICLE TYPE RATE UNIT USEAGE

$0.00

$0.00

TOTAL VEHICLE $0.00

PER DIEM STAFF RATE UNIT USEAGE

$0.00

$0.00

TOTAL PER DIEM $0.00

SUBCONTRACTOR COSTS

NAME PURPOSE COST

$0.00

TOTAL $0.00

LABORATORY COSTS

PARAMETER RATE # SAMPLES #QAQC

$0.00

$0.00

TOTAL LAB $0.00

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

$0.00

$0.00

$0.00TOTAL EQUIPMENT

FINAL --7/24/96

October 4, 2024

John Daugherty Environmental Project Scientist Building & Construction Intertek-PSI Direct +1 615 848 8516 Email john.daugherty@intertek.com www.intertek.com/building

Re: Haines City Mall System Removal 511 US HWY 17-92, Haines City, Dear Mr. Daugherty:

Pursuant to your request, Action Environmental, (Action) is pleased to provide you the following proposal to remove the treatment system trailer/system located in Haines City, Florida.

Scope of Work Mobilization to the above referenced site.

Temporary removal and replacement of compound wooden fencing (remove ample fence sections) in order to provide access to (and removal of) system trailer.

Lock out/tag out the electrical system at the main breaker disconnect.

Remove electrical conductors between the main disconnect and SVE system trailer and cap the electrical conduit above grade once removed.

Disconnect SVE system trailer from any anchor points or tie-downs, and load onto vehicle/trailer and transport the trailer to the FDEP Lakeland Storage Yard located near 8345 State Road 33 Lakeland, FL 33809.

Re-install previously removed fence sections once the trailer has been removed from the compound.

Paint with high-visibility color any anchor points, or other above-grade hardware associated with the SVE system that will remain on-site.

Disconnect manifold and cap remaining SVE stick-ups (above grade with sufficient length to remove the cap and couple to the remaining pipe).

Cost: $2475 Lump Sum

Assumptions & Conditions No permit Power disconnected by others prior to mobilization Assumes wires can be pulled out by hand.

Assumes tires are in good condition.

We appreciate the opportunity to be of service to you. Feel free to contact me on my mobile phone 813-545-5236 should you have any questions or comments regarding this proposal.

Sincerely, Action Environmental

Josh Pryor, EI Construction Division Manager

1013 BRIARWOOD DRIVE

WAUCHULA, FL 33873

(863-781-6971 wdenviro@gmail.com

INTERTEK

PSI/Intertek 5801 Benjamin Center Drive Suite 112 Tampa FL 33634

1592 10/30/2024

ACTIVITY QTY RATE AMOUNT

Project Location:

511 Haines City Mall Haines City FL

WD is to partially remove fencing around system to access trailer and associated piping.

WD is to disconnect system, remove system trailer and transport off-site. WD is to remove and cap associated pipes to grade. WD is to "lockout/tag-out" power supply at breaker box system. WD is to paint any anchor points or associated hardware with high visibility paint. WD is to reassemble any fence panels that were removed.

1 6,500.00 6,500.00

TOTAL

Accepted By Accepted Date

04/24/2024 01:44 PM PAGE 1 OF 7

Scope of Work pricing is based on an approved non hazardous facility in to Enviroserve Mulberry

4600 BROOKPARK ROAD, CLEVELAND,

OHIO, 44134

(216) 642-1311

(216) 642-1474

QUOTE #: 0042802

DATE: 04/24/2024 PROJECT PROPOSAL

CLIENT

JOSH NEWELL

INTERTEK/PSI - PLANT CITY

607 SOUTH ALEXANDER ST, SUITE 202, PLANT CITY, FLORIDA,

33563

P: (863) 712-4342

E-MAIL:JOSHUA.NEWELL@INTERTEK.COM

PROJECT DESCRIPTION

FDEP DRY CLEANING DRUMS

FDEP

THE FOLLOWING DESCRIBES OUR UNDERSTANDING OF THE SCOPE OF SERVICES TO BE PERFORMED BY ENVIROSERVE, FOR THE

CLIENT, AT THE ABOVE REFERENCED LOCATION KNOWN AS THE JOB SITE.

FEE STRUCTURE

TRANSPORTATION

ITEM EST.QTY. UNIT PRICE UNIT TOTAL

TRANSPORTATION - LTL DRUM (6 - 55 GAL) - 251-400 MILES 1.00 $50.00 DRUM $50.00

LOW STOP FEE (LESS THAN 6 DRUMS) 1.00 $50.00 55 GAL DRUM $50.00

ENERGY SURCHARGE (APPLIES TO TOTAL INVOICE) - $15.00 % -

TRANSPORTATION SUBTOTAL: $100.00

DISPOSAL

ITEM EST.QTY. UNIT PRICE UNIT TOTAL

55 GAL DRUM / SOLID 1.00 $80.00 EACH $80.00

DISPOSAL SUBTOTAL: $80.00

JOB ESTIMATE: $180.00

ENVIRONMENTAL FEE: $9.00

TOTAL JOB ESTIMATE: $189.00