CN-370000-LE705-4i-61976.pdf

This is a Work Authorization Form issued by the Florida Department of Environmental Protection, Office of Emergency Response. The document authorizes work to be performed by PermaPix under Contract LE705, with Glenn Byer serving as the company representative. The work is being conducted at the FDEP SW District site located at 13951 N Tamiami Pkwy in Temple Terrace, Hillsborough County, Florida. The incident is identified as DEP Incident #2018-4461976, dated November 29, 2018, with Jeff Tobergte designated as the On-Scene Coordinator.

The authorization covers lab-packing and shipping of wastes, with an estimated not-to-exceed amount of $5,000.00. The work involves field personnel including a supervisor and field chemist, utilization of a straight truck for transport, and provision of equipment including work clothes at Level D PPE and paperwork/labeling/lab-pack supplies. The materials to be handled consist primarily of laboratory wastes and spill wastes, with analysis to be conducted via contractor. The analytical and disposal arrangements specify that profiling of wastes will occur, with the generator identified as FDEP SW District under EPA ID# FLR000135442. The work assignment is designated as fixed price, and approval was granted by John Johnson (DEP Representative) with signature authority from Jeff Tobergte on November 29, 2018. Funding is allocated under Project LE705, Organization Code 3109010000, with charges to Fund 0949001, Category 101992.