CN-370000-LE619-4I54352.pdf
PDF 201 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. The document authorizes EQ Florida, Inc. to perform emergency response work under contract number LE619EQ. The incident, identified as DEP Incident #2015-4I-64352, occurred on December 28, 2015, at Force Road in Brooksville, Hernando County, Florida. The on-scene coordinator is Domenic LetoBarone, with Mr. Daniel McAllister serving as the contractor representative. The form was approved and digitally signed by all required parties on December 29-30, 2015.
The work authorization covers the removal and transport of three 55-gallon polyethylene drums containing used motor oil located at the specified site. The drums—two full and one approximately one-third full—require overpacking due to deteriorating plastic conditions with potential cracking. The scope of work includes overpack drum preparation, transport to a treatment storage and disposal facility (TSDF), straight truck transportation, and provision of necessary equipment including a lift-gate and drum dolly. All materials are profiled as hazardous waste (D001, D006, D007, D008, D018, F003, and F005) under Florida DEP and EPA ID #FL0000124784. The work is classified as fixed price with an estimated amount of $1,900.00, funded through Project Number LE619, Organization Code 37040100000, and Object Code 139900. The authorization includes reimbursement potential marked as "no," with funding provided through grant category 099001.
View the file
Other files
Show 40 more
50 files listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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)
EQ Florida, Inc. 2015-4I-54352
LE619EQ Mr. Daniel McAllister 12-28-2015
3 x 55-gallon poly drums of used oil Domenic LetoBarone
Force Road (N28.66136, W-82.50584) (813) 470-5954
Brooksville Hernando (813) 299-3608
✔ Schedule removal for 12-30-15 at 9:30 a.m. *On-Scene*
✔ ✔ ✔ 3
3 x 55-gallon poly drums containing used motor oil. 2 drums are full and 1 drum is approximatley 1/3 full. All three drums will require overpacks.
3 x 85
Level D (leather gloves)
Lift-gate & drum dolly
✔ All Paperwork & Labels
All three drums are secured, but will require over-packs due to the condition of the plastic, possible cracking could occur.
✔ D001, D006, D007, D008 D018, F003, and F005 (Used Motor Oil), FL DEP, EPA ID# FL0000124784
1,900.00
LE619 37040100000 FL 139900 102577 099001 $1900. 00
Domenic LetoBarone Domenic LetoBarone Digitally signed by Domenic LetoBarone Date: 2015.12.29 09:45:40 -05'00' 12/29/15
Joel Conrad joel.conrad@eqonline.com Digitally signed by joel.conrad@eqonline.com DN: cn=joel.conrad@eqonline.com Date: 2015.12.29 10:52:29 -05'00' 12/29/15
Amanda Hartsfield Amanda Hartsfield Digitally signed by Amanda Hartsfield Date: 2015.12.30 10:08:07 -05'00' 12/30/15 letobarone_d Highlight letobarone_d Highlight letobarone_d Highlight
File details come from the government source that posted it. Updated .