CN-370000-LE680-31-58789.pdf
PDF 224 KB Posted
- Contract number
- LE680
- Issued by
- Florida
About this file
This is a Work Authorization Form (WAF) issued by the Florida Department of Environmental Protection (DEP), Office of Emergency Response, authorizing work under an existing indefinite delivery contract. The contractor is SWS (Specialized Waste Services), operating under Contract #LE680. The incident, identified as DEP Incident #2017-3I-58789, occurred on August 24, 2017, at SR 29 and F Road in LaBelle, Hendry County, Florida. The On-Scene Coordinator is Heidi Hoffman, with contact information provided for both office and mobile communication.
The authorized work involves spill response and soil removal related to a diesel fuel, hydraulic fluid, and motor oil release totaling 50 gallons. The scope includes one supervisor, one recovery technician, and one equipment operator utilizing a response trailer, dump trucks, vacuum truck, pickup/van, backhoe, and nine 55-gallon drums. Specialized equipment includes PPE Level D and a vapor detector. The work is estimated at a cost of $22,717.00 on a cost estimate basis, with reimbursement potential through responsible party reimbursement. Funding is allocated under Project No. LE680, Organization Code 37040100000, Object Code 139900, Fund 099001, and Module/OCA 101492. The WAF was approved on November 30, 2017, by DEP Representative Heidi Hoffman, with contractor approval by Ed Goodchild on December 1, 2017, and OER Budget Representative approval by Alexa Escobar Paez on December 8, 2017.
View the file
Other files
Show 40 more
Latest 50 of 312 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)
Prior Approval received by printed name: Signature
SWS 2017-3I-58789
LE680 August 24, 2017
Gonzalez / Rapid Trucking Heidi Hoffman
SR 29 and F Rd. (239) 344-5684
LaBelle Hendry (239) 872-2323
✔ 12/13/2017, 9am
Diesel fuel, hydraulic fluid, and motor oil (50 gallons total)
D
Response Trailer, Dump Trucks
Long-stick excavator required due to terrain, per SWS.
✔ 22,717.00
LE680 37040100000 FC 139900 099001 101492 - - 22,717 00
Heidi Hoffman Heidi Hoffman Digitally signed by Heidi Hoffman Date: 2017.11.30 14:59:25 -05'00' 11/30/17
Ed Goodchild ed.goodchild@swsenvironmental.com Digitally signed by ed.goodchild@swsenvironmental.com DN: cn=ed.goodchild@swsenvironmental.com Date: 2017.12.01 16:44:14 -05'00'
Alexa Escobar Paez Digitally signed by Alexa Escobar Paez Date: 2017.12.08 15:30:02 -05'00' 12/8/17
John Johnson
File details come from the government source that posted it. Updated .