CN-370000-LE807-3I69771.pdf
PDF 232 KB Posted
- Contract number
- LE807
- Issued by
- Florida
About this file
This is a Work Authorization Form (OER_13) issued by the Florida Department of Environmental Protection (FDEP), Office of Emergency Response (OER). The document authorizes work for ACT 2023-3I-69771 involving All DI Best Transport LLC as the contractor, with Lauren Johnson serving as the FDEP representative and Heidi Hoffman as the contractor representative. The incident occurred on January 7, 2023, at a site in Arcadia, DeSoto County, Florida, identified as CR-761 and CR-769.
The authorized work includes spill response activities with soil removal and sampling services. Specific level of effort resources include one supervisor, one recovery technician, and one equipment operator, along with a vacuum truck, pickup/van, and sampling equipment at EPA Level 1 and Level 2 with a vapor detector and PPE Level D. The contractor will handle analytical and disposal arrangements. The work assignment is fixed price with a not-to-exceed estimate of $8,100.00. Funding is allocated from Project No. LE807, Organization Code 37040100000, Object Code 131545, Fund Category 099001, with amount 101492. All required signatures were obtained on February 1, 2023, from the DEP representative, contractor representative, and OER budget representative.
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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
ACT 2023-3I-69771
LE807 Lauren Johnson January 7, 2023
All DI Best Transport LLC Heidi Hoffman
CR-761 and CR-769 (239) 344-5684
Arcadia DeSoto (239) 872-2323
Diesel - 20 gallons
1 D
Jet truck being used to avoid utilities
8100.00
LE807 37040100000 FC 131545 099001 101492 8100 00
Heidi Hoffman February 1, 2023
Lauren Johnson February 1, 2023
Amanda Lanphere February 1, 2023
Samuel Graves
Temp well installation
Amanda Lanphere Digitally signed by Amanda Lanphere Date: 2023.02.01 14:56:09 -05'00'
Lauren Johnson Digitally signed by Lauren Johnson Date: 2023.02.01 12:31:42 -05'00'
Heidi Hoffman Digitally signed by Heidi Hoffman Date: 2023.02.01 12:24:34 -05'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2023.02.01 15:05:41 -05'00'
File details come from the government source that posted it. Updated .