CN-370000-LE619-4I53803.pdf
PDF 227 KB Posted
- Contract number
- LE619
- Issued by
- Florida
About this file
This is a Work Authorization Form (WAF) issued by the Florida Department of Environmental Protection (FDEP), Office of Emergency Response, authorizing US Ecology (formerly EQ Florida, Inc.) to perform emergency response services. The form documents authorization under Contract LE 619 for incident 2015-4I-53803, occurring on September 27, 2015, at the Hillsborough River Abandoned Drums site in Thonotosassa, Hillsborough County, Florida. The On-Scene Coordinator (OSC) is Pete Wenner, with emergency response directed to occur on Thursday, October 1, 2015, in mid-morning.
The work involves the removal of two abandoned drums (approximately 33 gallons per drum, 66 gallons total) containing waste oil, gasoline, and possibly other solvents from a swamp location 15 feet down an embankment, requiring specialized equipment including winch, rope, and drum straps. The contractor will deploy two recovery technicians and a pickup vehicle with winch capability. Hazardous waste profiles are classified under EPA codes D001, D006, D007, D008, D018, F002, F003, and F005. The work is assigned as a fixed-price contract with an estimated amount of $2,000.00, funded through Project LE619 using state funds (Fund 102577, Object Code 139900). No reimbursement potential from responsible parties or OPA-'90 provisions is indicated. The WAF was executed and approved by all required parties on September 30, 2015, with final budget authorization on October 7, 2015.
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Text version
Florida Department of Environmental Protection
Office of Emergency Response
WORK AUTHORIZATION FORM
Required Signatures: Adobe Signature or Original Ink Supplemental WAF
Contractor: ____________________________________ DEP Incident # ______________________ Contract #: ___________ Rep: ____________________ Incident Date _______________________ Site Name: ____________________________________ OSC: ______________________________ Location: ______________________________________ Phone: Office______________________ City: __________________County: _________________ Cell ________________________
Description of Work: Respond Immediately Call OSC to set date/time__________________________________
Spill Response Overpack Drums Transport drums to TSA Abandoned Drum:
Remove Soil Sampling Transport Drums to TSDF Analysis of samples collected by OER
Other:
Suspected Materials, and amounts: _____________________________________________________________________________________
Level of Effort: (Check all that apply) Use Subcontractor per OSC
Personnel Vehicles Equipment
Supervisor: ____ Response Truck Overpack Drums: Visqueen
Recovery Tech: ____ Straight Truck 55-gal. Drums: Roll-off Containers: ___________
Field Chemist: ____ Vacuum Truck Sampling Gear EPA Level 1 Vapor Detector
Equip. Oper.: ____ Pickup or Van Sampling Gear EPA Level 2 PPE Level: __________________
Other: ____________ Backhoe or Similar Other: ________________ MOT
Other: ____________ Other: ____________ Other:______________________
Comments: ___________________________________________________________________________________________________________
Analytical & Disposal Arrangements: (analytical will usually be listed on Chain-of-Custody or other form)
Via Contractor Via Subcontractor Other: ________________________________________________
Profile Wastes as:
Work Assignment Type: fixed price cost estimate est’d amount: $____________________________
Reimbursement Potential: no yes OPA-’90 reimbursement Resp. Party Reimbursement
Funding Information: (information provided by OER budget rep., budget rep to sign after WAF executed, but prior to transmittal to F&A)
Project No. Organization Code EO Object Code Fund Category/Yr
Module/ OCA Grant Amount
Approved:
DEP Representative: __________________________ Signature: _______________________________ Date: __________________
Contractor Rep: __________________________ Signature: ___________________________________ Date: __________________
OER Budget Rep: __________________________ Signature: __________________________________ Date: __________________ OER_13 (Effective 9-14-2015)
Prior Approval received by printed name: Signature
US Ecology (f/k/a: EQ Florida, Inc.) 2015-4I-53803
LE 619 Daniel McAllister 27 September 2015
Hillsborough River Abandoned Drums Pete Wenner
13713 US 301 (813) 470-5954
Thonotosassa Hillsborough (813) 376-6490
✔ Thursday, 1 October 2015, mid-morning
✔ ✔ 2
✔ Removal of drums will require use of winch, rope and drum strap as they are in a swamp down a 15' embankment
Waste oil, gasoline & possibly other solvents; Volume: ~33-gallons/drum
Total volume: ~66-gallons for 2 drums
Work Clothes
Pickup with winch
Removal of drums will require use of winch, rope and drum strap as they are in a swamp down a 15' embankment
✔ D001, D006, D007, D008, D018, F002, F003, F005, 2,000.00
LE619 37040100000 FL 139900 102577 099001 2000 00
Peter Wenner Wenner_P Digitally signed by Wenner_P Date: 2015.09.30 10:26:12 -04'00' 9/30/15
Daniel McAllister daniel.mcallister@eqonline.com Digitally signed by daniel.mcallister@eqonline.com DN: cn=daniel.mcallister@eqonline.com Date: 2015.09.30 11:50:01 -04'00' 9/30/15
Amanda Hartsfield Amanda Hartsfield Digitally signed by Amanda Hartsfield Date: 2015.10.07 13:32:39 -04'00' 10/7/15
John Johnson John Johnson Digitally signed by John Johnson Date: 2015.09.30 12:55:22 -04'00'
File details come from the government source that posted it. Updated .