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

HW009A Completion October 27, 2023

This Task Assignment authorizes Professional Service Industries, Inc. (PSI) to conduct PFAS sampling in accordance with the PSI scope of work, cost estimate, and schedule received on January 10 2023.

Skylar Schwed 850-245-8795 Contractor Contractor

Contractor Contractor

Contractor Contractor

Contractor

Professional Service Industries, Inc. (Intertek-PSI)

Professional Service Industries, Inc. (Intertek-PSI)

Nana G. Westmark 813-886-1075

ERIC_4721

14616 Livingston Avenue Lutz, Hillsborough County, Florida

Palm Cleaners

✔ $ 1,653.86

$ 1,653.86

Scope of Work

Nana Westmark

Senior Geologist / Principal Consultant

Nana G Westmark Digitally signed by Nana G Westmark Date: 2023.01.25 14:25:38 -05'00' Kelly Crain Digitally signed by Kelly Crain

Date: 2023.01.20 13:55:06 -05'00'

N/A

Murphy_SL Highlight

Murphy_SL Highlight

Murphy_SL Highlight

Murphy_SL Highlight

Murphy_SL Highlight

Task Assignment Notification/Change Order Deliverables and Invoice Schedule Attachment

WCP TAFORM 04-2017

Contract Number:

Task Assignment #:

Deliverables:

Deliverable Deliverable Due Date

Invoice Schedule:

Requirements for Invoice Submittal Amount to be Invoiced

TOTAL COST

Subtasks 1 & 2 Groundwater monitoring/ PFAS email deliverable & Project Management 08/28/2023

Subtasks 1 & 2 Submittal and FDEP approval of the Groundwater monitoring/ PFAS email deliverable & Project Management $ 1,653.86

$ 1,653.86

HW686

HW009A

Printed on recycled paper.

FLORIDA DEPARTMENT OF

Environmental Protection

Bob Martinez Center 2600 Blair Stone Road

Tallahassee, FL 32399-2400

Ron DeSantis Governor

Jeanette Nuñez Lt. Governor

Shawn Hamilton Secretary

To:

From:

Date:

HW686 Contract Negotiation File Palm Cleaners Lutz, Hillsborough County, Florida

ERIC_4721

Skylar Schwed, Project Manager January 19, 2023

Subject: Negotiation Summary

HW686 HW009A

This Task Assignment authorizes PSI to conduct groundwater monitoring activities in accordance with the January 10, 2023, Scope of Work, and Cost Estimate.

PSI confirmed on January 10, 2023, that an Access Agreement with the current real property owner of the Palm Cleaners (ERIC_4721) site has been executed.

The original Task Assignment totaled $1,653.86 with 17 labor hours but after negotiations and corrections with the contractor costs are reflected below:

The FDEP Project Manager agrees to the scope of work and final cost associated with this Task Assignment. The final cost for this Task Assignment is $1,653.86with 17 labor hours.

PSI may invoice following the schedule established in the Deliverables and Invoice Schedule Attachment, which accompanies the Task Assignment Notification Form.

FDEP COST ESTIMATEContractor: Professional Service Industries, Inc. (Intertek-PSI)

Date: 1/10/2023

Task #: SubTask 1 Project Management SubTask 6

Site: Palm Cleaners ERIC_4721 SubTask 2 Groundwater Monitoring / Email Deliverable SubTask 7

Activity/Phase: Groundwater Monitoring - PFAS SubTask 3 SubTask 8

Project Manager: Nana Westmark SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10 Labor Rate Category

$56.99 Project Manager 1 1.2 $0.00 Principal Consultant 0 0.0 0 0 0 0 0 0 0 0

$60.00 Senior Engineer, MR 0 0.0 0 0 0 0 0 0 0 0 $56.99 Senior Geologist, NW 3 3.0 0 0 0 0 0 0 0 0 $64.90 Senior Scientist, DC 0 0.0 0 0 0 0 0 0 0 0

$0.00 Certified Industrial Hygientist 0 0.0 0 0 0 0 0 0 0 0 $0.00 Certified Hazardous Materials Manager 0 0.0 0 0 0 0 0 0 0 0 $0.00 Florida Licensed Asbestos Consultant 0 0.0 0 0 0 0 0 0 0 0 $0.00 Project Manager 0 0.0 0 0 0 0 0 0 0 0

$36.06 Project Engineer 0 0.0 0 0 0 0 0 0 0 0 $43.27 Project Engineer, IK 0 0.0 0 0 0 0 0 0 0 0 $40.87 Project Engineer, MK 0 0.0 0 0 0 0 0 0 0 0 $43.27 Project Engineer, JN 0 0.0 0 0 0 0 0 0 0 0 $33.74 Project Scientist, SB 0 0.0 0 0 0 0 0 0 0 0 $37.00 Project Scientist, SAM 0 0.0 0 0 0 0 0 0 0 0 $29.77 Project Scientist, RF 0 0.0 0 0 0 0 0 0 0 0

$0.00 QA Officer 0 0.0 0 0 0 0 0 0 0 0 $31.51 Remediation Specialist, RH 6 6.0 0 0 0 0 0 0 0 0 $29.86 GIS / CAD Specialist, DG 2 2.0 0 0 0 0 0 0 0 0 $24.04 Staff Scientist, OG 0 0.0 0 0 0 0 0 0 0 0 $28.85 Staff Geologist, RP 0 0.0 0 0 0 0 0 0 0 0 $25.00 Staff Scientist, QH 0 0.0 0 0 0 0 0 0 0 0 $30.91 Environmental Specialist, CC 0 0.0 0 0 0 0 0 0 0 0 $22.06 Environmental Specialist, MZ 5 5.0 0 0 0 0 0 0 0 0 $20.81 Administrative Assistant, BM 0 0.0 0 0 0 0 0 0 0 0

$0.00 0 0.0 0 0 0 0 0 0 0 0 $0.00 0 0.0 0 0 0 0 0 0 0 0 $0.00 0 0.0 0 0 0 0 0 0 0 0 $0.00 0 0.0 0 0 0 0 0 0 0 0 $0.00 0 0.0 0 0 0 0 0 0 0 0 $0.00 0 0.0 0 0 0 0 0 0 0 0

Total Hours 17 1 16.0 0 0 0 0 0 0 0 0

Direct Labor $598.96 $68.91 $530.05 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Overhead 151.02% $904.55 $104.07 $800.48 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Gen & Admin 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fringe 0.00% $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Labor $1,503.51 $172.98 $1,330.53 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF Intertek-PSI Page 1

FDEP COST ESTIMATEContractor: Professional Service Industries, Inc. (Intertek-PSI)

Date: 1/10/2023

Task #: SubTask 1 Project Management SubTask 6

Site: Palm Cleaners ERIC_4721 SubTask 2 Groundwater Monitoring / Email Deliverable SubTask 7

Activity/Phase: Groundwater Monitoring - PFAS SubTask 3 SubTask 8

Project Manager: Nana Westmark SubTask 4 SubTask 9

SubTask 5 SubTask 10

Totals 1 2 3 4 5 6 7 8 9 10

Travel Vehicle Rental $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mileage Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Air Fare $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Per diem + Hotel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Travel $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Equipment Procurement) $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 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Procurement Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subcontractor (Services Procurement) Drilling (Conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Drilling (Non-conventional) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Mobile Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Surveying $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

IDW $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Utilities $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 $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

Subcontractor Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Handling Fee $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Subcontractor Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Laboratory Analytical Costs $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Fast Turnaround Charges $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Sample Shipping $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Laboratory $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Field Expenses Personal Protection $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Expendables $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Drilling related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Analytical related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (IDW related) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Equipment (Other) $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Field Expenses $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Subtotal $1,503.51 $172.98 $1,330.53 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Completion Fee $150.35 $17.30 $133.05 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Total Estimated Cost $1,653.86 $190.28 $1,463.58 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

REV: 02/03 CEF Intertek-PSI Page 2

LEVEL OF EFFORT/EXPENSE WORKSHEET

SITE : Palm Cleaners ERIC_4721 SubTask 2 Groundwater Monitoring / Email Deliverable

DATE: 1/10/2023

LABOR CATEGORY *PROVIDE TIME REQUIRED FOR EACH PERSON

STAFF-TITLE WORK DESCRIPTION HOURS

PFAS Sampling Environmental Specialist, M Zilske

Collect groundwater samples 3 shallow wells @ 1 hr each 3 Additional decontamination for PFAS 1 Stage IDW 1

Total Hours: 5

Remediation Specialist, R Hanson Field Event Preparation 1 Collect groundwater samples (1 inter) intermediate wells @ 1.5 hr each 1.5 Additional decontamination for PFAS 1 Inventory cooler, prepare cooler for shipping to FDEP 2.5

Total Hours: 6

CADD/ GIS, D Grove Prepare map with PFAS results Total Hours: 2

Senior Geologist, N Westmark Technical oversight 1 Provide Evaluation and email summary 2

Total Hours: 3

TOTAL LABOR 16

VEHICLE TYPE RATE UNIT USEAGE

$0.00

Equipment Van / Truck $120.00 day 0 $0.00

$0.00

TOTAL VEHICLE $0.00

PER DIEM STAFF RATE UNIT USEAGE

$0.00 $0.00 $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 0 $0.00

$0.00 $0.00

$0.00

TOTAL LAB $0.00

EQUIPMENT ITEM RATE COSTING UNIT USEAGE TOTALS

$0.00

Shallow Groundwater Sampling Kit $290.00 day 0 $0.00

$0.00 Expendables $40.00 day 0 $0.00

TOTAL EQUIPMENT $0.00

Analaytical laboratory services for PFAS provided by FDEP Central Laboratory

FINAL --7/24/96

Page 4 Palm Cleaners ERIC_4721 0552-390383

PSI Proposal: 0552-390383 January 10, 2023

Professional Service Industries, Inc.

5801 Benjamin Center Drive, Suite 112, Tampa, FL 33634

Phone: (813) 886-1075 Fax: (813) 249-4916 www.intertek.com/building

Florida Department of Environmental Protection Waste Site Cleanup Section 2600 Blair Stone Road, MS 4520 Tallahassee, Florida 32399-2400

Attention: Ms. Skylar Schwed, Environmental Specialist III, Contract Manager Phone: (850) 245-8705 main, (850) 245-8795 direct Email: Skylar.Schwed@FloridaDEP.gov

Re: Proposal for PFAS Groundwater Sampling and Summary Palm Dry Cleaners ERIC_4721 14616 Livingston Avenue Lutz, Hillsborough County, Florida

Dear Ms. Schwed:

Professional Service Industries, Inc. (PSI), an Intertek company, is pleased to provide the proposal contained herein to provide Groundwater Sampling Services for the Palm Dry Cleaners ERIC_4721, Lutz, Florida. Included with this proposal is a discussion of project history to date, proposed scope of work, cost estimate and a proposed schedule for completion. According to the signed access form from May 2022, the same property owner is listed in the November 2022 property appraiser’s website for Hillsborough County.

PROJECT BACKGROUND

The FDEP is currently implementing the August 2021 Waste Cleanup Section Dynamic Plan for addressing PFAS which consists of monitoring drycleaning sites with close proximity to public wells. Therefore, we are proposing to conduct a groundwater sampling event for select wells (to be selected / installed during the Site Assessment) at the Palm Cleaners to evaluate the potential presence of PFAS compounds. The sampling event will occur concurrently with the Site Assessment scheduled to start in April 2023. The FDEP Central Laboratory in Tallahassee will provide the PFAS analytical services.

PROPOSED SCOPE OF WORK

The proposed groundwater sampling activities will be implemented in general accordance with the FDEP’s Standard Operating Procedures for Field Activities (DEP SOP-001/01) and the site mailto:Skylar.Schwed@FloridaDEP.gov

FDEP – Palm Cleaners ERIC_4721

Groundwater Sampling - PFAS

Health and Safety Plan developed for this project. Based upon our discussion, this proposal generally includes the following activities:

• Collect groundwater samples from existing select wells for PFAS analysis including perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS),

• Utilize the FDEP Laboratory in Tallahassee for sample kits and all laboratory analysis as required for these activities, and

• Provide summary deliverable.

Specifically, the proposed scope of work consists of the following subtasks:

1. Project Management

This scope is provided for in the template worksheets.

2. Groundwater Sampling

a. Collect the following samples for PFAS analyses by the FDEP laboratory.

I. Three shallow wells (locations to be determined with the FDEP upon installation during the Site Assessment), II. One intermediate well (location to be determined with the FDEP upon installation during the Site Assessment).

b. All IDW (purge water and wash water) will be handled and disposed of in accordance with FDEP and USEPA guidelines.

c. Provide a deliverable in accordance with WSCS PFAS Screening Plan for Drycleaning Sites, which will include a simple email summary including one figure with text boxes (no isoconcentration contours), field notes/forms, and the final laboratory report.

COST ESTIMATE AND SCHEDULE

The estimated cost to perform the Groundwater Sampling Services is shown on the attached Cost Estimate. All PSI services will be conducted in accordance with the terms and conditions contained within DEP Contract No. HW 686, Waste Cleanup Program Services, dated December 21, 2021. An invoice and deliverable schedule are presented as follows.

FDEP – Palm Cleaners ERIC_4721

Groundwater Sampling - PFAS

Palm Cleaners ERIC_4721

Deliverables

Deliverables Deliverable Due Date SubTask 1 Project Management August 28, 2023 SubTask 2 Groundwater Monitoring / Email

Deliverable Two days within receipt of FDEP lab data if above PGCTLs

Invoice Schedule

Requirements for Invoice Submittal Amount to be Invoiced SubTasks 1 & 2 - Submittal & approval of Groundwater Monitoring Email Results

$1,653.86

PSI appreciates the opportunity to be of service to the FDEP. If you have any questions, please feel free to contact us at (813) 886-1075 or (813) 267-2519.

Respectfully submitted, PROFESSIONAL SERVICE INDUSTRIES, INC.

Ryan Fetter Nana Westmark, PG, CHMM Project Scientist Senior Geologist / Contract Manager

Enclosure: Cost Estimate Level of Effort

Z:\552-Env\FDEP HW 686 Drycleaning, Main Contract\0552------Palm Cleaners PFAS GW\Proposals\Palm Cleaners ERIC_4721 0552-390383.docx