CN-370000-LE807-3I70079S.pdf
PDF 160 KB Posted
- Contract number
- LE807
- Issued by
- Florida
About this file
Work Authorization Summary
This is a Work Authorization Form (WAF) issued by the Florida Department of Environmental Protection (FDEP), Office of Emergency Response (OER), for emergency response services provided by ACT under Contract LE807. The authorization was executed on September 26-29, 2023, in response to DEP Incident #2023-3I-70079, occurring on June 2, 2023, at the South District OER Shed located at 2981 Pine Island Road, Cape Coral, Lee County, Florida. The incident was overseen by OSC David Glenn with coordination by FDEP representatives Melissa Woehle and Lauren Johnson.
The work scope encompasses spill response and soil removal activities, including disposal of impacted soil, with specific work elements including mini excavator and mini dump truck operations, source removal reporting, and chemist analysis. The contractor utilized personnel consisting of a supervisor, field chemist, equipment operator, and chemist, along with equipment including a backhoe, sampling gear, vapor detector, and PPE. The work was authorized on a cost-plus basis with a fixed price of $1,038.00. Funding was allocated from Project LE807, Organization Code 37040100000, with Object Code 131545 under Fund Category 101492. All required approvals were obtained from the DEP Representative, Contractor Representative, and OER Budget Representative prior to authorization.
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
ACT 2023-3I-70079
LE807 Lauren Johnson 06/02/2023
South District OER Shed David Glenn
2981 Pine Island Rd (239) 344-5681
Cape Coral Lee (239) 633-5441
Diesel- 8 gallons work clothes chemist Report and cost plus
Mini excavator and Mini dump truck, source removal report.
1,038.00
LE807 37040100000 FC 131545 099001 101492 $1,038 00
Melissa Woehle 09-26.2023
Lauren Johnson 9-26-2023
Amanda LAnphere 9/29/2023
Samuel Graves
Disposal of impacted soil.
Amanda Lanphere Digitally signed by Amanda Lanphere Date: 2023.09.29 11:02:33 -04'00'
Lauren Johnson Digitally signed by Lauren Johnson Date: 2023.09.26 16:56:47 -04'00'
Melissa Woehle Digitally signed by Melissa Woehle Date: 2023.09.26 16:52:13 -04'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2023.09.29 11:29:44 -04'00'
File details come from the government source that posted it. Updated .