CN-370000-LE706-4C-66168.pdf
PDF 232 KB Posted
- Contract number
- LE706
- 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 (OER), authorizing work to be performed by Cliff Berry Inc. under Contract #LE706. The authorization covers emergency response services at the Reddington Shores site in Pinellas County, Florida, following a spill incident dated August 18, 2020. The On-Scene Coordinator (OSC) for this incident is Jordan Luscier, with primary contact through FDEP representative Nicole Collins and OER budget representative Kristin Gousse.
The work authorization covers the recovery and transport of an abandoned blue 55-gallon polyethylene drum containing red-dyed diesel fuel. Authorized services include immediate response, overpack drums, transport to a Treatment, Storage, and Disposal Facility (TSDF), and abandoned drum handling. The level of effort includes one supervisor and one recovery technician, along with a straight truck and one overpack drum. The work is assigned as a fixed-price contract with a Not to Exceed amount of $901. Funding is allocated from Project Number LE706, Organization Code 37040100000, Object Code 139900, under Fund Category 212001 (104132), for a total amount of $901. The work was authorized on August 19, 2020, with all required signatures executed digitally on that date.
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
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
Cliff Berry Inc. 2020-4C-66168
LE706 Jon Sandora 8/18/20
Reddington Shores Jordan Luscier
155 174th Ave 813-470-5791
Redington Shores Pinellas 813-267-3521 call to schedule a time for 8/19/20 a blue 55-gallon poly drum full of red-dyed diesel
Level D
Labeks
. I would suggest that CBI bring 2 new plastic bungs, and possibly an over-pack. The drum should be shippable as it is, but the overpack would be a precaution if needed
LE706 37040100000 JC 139900 212001 104132 901
Jordan Luscier 8/19/20
Nicole Collins - Cliff Berry Inc. 08/19/20
Kristin Gousse 8/19/2020
Melissa Woehle
Diesel Fuel
Bring all necessary labels, placards, and paperwork.
Kristin Gousse Digitally signed by Kristin Gousse Date: 2020.08.19 14:11:49 -04'00'
Nicole Collins Digitally signed by Nicole Collins Date: 2020.08.19 11:44:56 -04'00'
Jordan Luscier Digitally signed by Jordan Luscier Date: 2020.08.19 10:27:23 -04'00'
Melissa Woehle Digitally signed by Melissa Woehle Date: 2020.08.19 13:47:57 -04'00'
File details come from the government source that posted it. Updated .