CN-370000-LE807-4I-68923.pdf

This is a Work Authorization Form (WAF) issued by the Florida Department of Environmental Protection, Office of Emergency Response, dated April 12, 2023. The document authorizes work under Contract No. LESM 207 with contractor A-C-T, represented by Jason Huffman. The work site is located at SR-66 & Grass Valley Ranch Rd near Zolfo Springs in Hardee County, Florida. The authorization references DEP Incident #2023-4I-889232 and identifies Jonathan Belcher as the responsible OSC (On-Scene Coordinator) with contact information provided.

The work scope includes immediate response for a diesel spill of approximately 240 gallons, specifically addressing spill response and soil removal. The authorization requires one supervisor and two recovery technicians, along with specified equipment including a response truck, pickup van, visqueen, vapor detector, and PPE level C protection. The work is assigned as a fixed-price contract with a not-to-exceed estimate amount of $19,000. Analytical and disposal arrangements will be handled via contractor, with funding sourced through Project No. LE-207, Organization Code 3-70440100000, EO FC, Object Code 135145, and Fund 0990001. The document was approved on April 12, 2023, by DEP Representative Jon Belcher, with contractor and OER budget representative signatures dated accordingly.