CN-370000-LE680-8I-63825.pdf
PDF 131 KB Posted
- Contract number
- LE680
- Issued by
- Florida
About this file
This is a Work Authorization Form (OER_13, effective July 1, 2017) issued by the Florida Department of Environmental Protection's Office of Emergency Response. The form authorizes emergency response services under Contract ADM680 with SWS-NRCC (LE680). The incident involved a diesel and oil spill in Lost Creek near US 319 north of SR 267 in Wakulla County, Florida, with Melissa Woehle designated as the On-Scene Coordinator.
The work authorization covers immediate spill response services for an estimated 100 gallons of diesel and oil mixed with water in a roadside ditch. The authorized level of effort includes one supervisor and one equipment operator, a vacuum truck, and a bale of absorbent pads for cleanup. Analytical and disposal arrangements are handled via the contractor at cost-plus pricing. The work assignment is structured as a fixed-price authorization with a not-to-exceed amount of $2,500.00, funded through Project LE680, Organization Code 37040100000, Object Code 139900, and Fund Category 099001 (101492). The authorization was executed on August 12, 2019, with signatures from the DEP Representative (Melissa Woehle), Contractor Representative (Ryan Napier), and OER Budget Representative (Brooke Kincaid).
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
OER_13 (Effective 7-01-2017)
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
Contract Rate: ____________
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 Not to Exceed estimate amount: $___________________________
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
Amount
Approved:
DEP Representative: __________________________ Signature: _______________________________ Date: __________________
Contractor Rep: __________________________ Signature: ___________________________________ Date: __________________
OER Budget Rep: __________________________ Signature: __________________________________ Date: __________________
Deliverable will be reviewed and evaluated by the DEP Contract Manager to ensure appropriate documentation reviewed and/or provided and that the documentation submitted is complete, accurate, and submitted timely
SWS - NRCC (LE680) 2019-8I-63825
ADM680 Ryan Napier 8/9/19
Lost Creek Solidworks - diesel spill Melissa Woehle
US 319 north of SR 267 850.245.2873
Crawfordville Wakulla 850.363.3695 responded immediately up to 100 gallons of diesel & oil mixed with water in ditch
1 work clothes bale of absorbent pads
Disposal will be at cost plus.
2,500
LE680 37040100000 FC 139900 099001 101492 $2,500.00
Melissa Woehle 08/12/19
Ryan Napier 8/12/2019
Brooke Kincaid 812/2019
Nick Roff
Brooke Kincaid Digitally signed by Brooke Kincaid Date: 2019.08.12 11:19:34 -04'00'
Ryan Napier Digitally signed by Ryan Napier Date: 2019.08.12 10:20:24 -04'00'
Melissa Woehle Digitally signed by Melissa Woehle Date: 2019.08.12 10:02:25 -04'00'
Nick Roff Digitally signed by Nick Roff Date: 2019.08.12 10:22:00 -04'00'
Woehle_M Highlight
File details come from the government source that posted it. Updated .