CN-370000-HW686-HW011A.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

HW011A Completion December 29, 2023

This Task Assignment authorizes Professional Service Industries, Inc. (PSI) to conduct PFAS Screening at 9 sites in accordance with the scope of work attached.

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 Multiple

Multiple

Multiple

✔ $ 30,600.00

$ 30,600.00

Scope of Work

Nana Westmark

Senior Geologist / Principal Consultant

Nana G Westmark Digitally signed by Nana G Westmark Date: 2023.05.26 09:26:12 -04'00' Kelly Crain Digitally signed by Kelly Crain

Date: 2023.05.09 11:16:08 -04'00'

N/A

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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

Subtask 1: PFAS Email summaries (one per site) with field notes & certified lab report for ERIC_5272 ERIC_5234 ERIC_5357 and ERIC_5423 10/02/2023

Subtask 2: PFAS Email summaries (one per site) with field notes & certified lab report for ERIC_5055 ERIC_4814 ERIC_4266 and ERIC_5481 11/01/2023

Subtask 3: PFAS Email summaries (one per site) with field notes & certified lab report for ERIC_4750 12/01/2023

Submittal and FDEP approval of the Subtask 1: PFAS Email summaries (one per site) with field notes & certified lab report for ERIC_5272 ERIC_5234 ERIC_5357 and

ERIC_5423

$ 13,600.00

Submittal and FDEP approval of the Subtask 2: PFAS Email summaries (one per site) with field notes & certified lab report for ERIC_5055 ERIC_4814 ERIC_4266 and ERIC_5481

$ 13,600.00

Submittal and FDEP approval of the Subtask 3: PFAS Email summaries (one per site) with field notes & certified lab report for ERIC_4750 $ 3,400.00

$ 30,600.00

HW686

HW011A

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

CLASSIC CLEANERS 4750

COASTAL CLEANERS 5272

CUSTOM COMMERCE LAUNDRY 5234

ELITE FASHION CARE 5055

HAINES CITY QUALITY CLEANERS INC 5357

MAIN STREET CLEANERS INC 5423

PUGHS DRY CLEANERS INC 4814

RENE DRY CLEANERS 4266

WYMORE CLEANERS 5481

PSI PFAS Sampling Sites under one (1) TA

Site Name ERIC ID Contractor PM Location Completion Date

CLASSIC CLEANERS

4750 PSI Skylar Schwed Tampa By November 2023

COASTAL CLEANERS

5272 PSI Skylar Schwed Dunedin By September 2023

CUSTOM COMMERCE LAUNDRY

5234 PSI Skylar Schwed New Port Richey

ELITE FASHION CARE

5055 PSI Skylar Schwed Orlando By October 2023

HAINES CITY QUALITY CLEANERS INC

5357 PSI Skylar Schwed Haines City

MAIN STREET CLEANERS INC

5423 PSI Skylar Schwed Sarasota

PUGHS DRY CLEANERS INC

4814 PSI Skylar Schwed Eustis

RENE DRY CLEANERS

4266 PSI Skylar Schwed Middleburg

WYMORE CLEANERS

5481 PSI Skylar Schwed Orlando

Springfield will be under a separate TA.