CN-370000-LE706-7C-68755.pdf

This is a Work Authorization Form issued by the Florida Department of Environmental Protection, Office of Emergency Response, dated April 21, 2022. The document authorizes work to be performed by Cliff Berry Incorporated (CBI) under Contract #LE-7706 at a location in Melbourne Beach, Brevard County, Florida. The incident is identified as DEP Incident #2022-TC-66755, with Mark Groothouse serving as the representative and Nichole Shumard and Monica Rendon listed as on-site coordinators.

The work authorization covers emergency response activities related to a 55-gallon poly drum containing diesel with an approximate 1/8-liter spill. The scope includes responding immediately to overpack drums, remove soil, transport drums to TSDF, and address an abandoned drum. Personnel authorized include a supervisor and equipment operator, with vehicles and equipment such as overpack drums available through the contractor. The work is assigned as fixed price with a not-to-exceed estimate of $1,000. Funding is provided through Project No. LE-7010, Organization Code 3-7401-00000, with EO FC-129960, Object Code 69-9001, Fund 101497, and Category/Year 0800. The document is authorized with signatures from the DEP Representative, Contractor Representative, and OER Budget Representative, all dated in April 2022.