CN-370000-LE807-4I-73030.pdf
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- Contract number
- LE807
- Issued by
- Florida
About this file
Work Authorization Form 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. The document authorizes work under Contract LE807 with ACT (contractor), identified by DEP Incident #2025-41-73030. The incident occurred on August 1, 2025, at 2776 CR 579 in Wimauma, Hillsborough County, Florida. The On-Scene Coordinator (OSC) is Jasson Drinkard. The form was executed with signatures from the DEP Representative, Contractor Representative, and OER Budget Representative between August 8, 2025, and October 16, 2025.
The authorized work includes spill response activities and soil removal at an abandoned drum site. The scope of work encompasses one supervisor, one recovery technician, one field chemist, and one equipment operator, along with a response truck, backhoe or similar equipment, and one roll-off container. Analytical services are to be arranged via the contractor. The work is structured as a fixed-price authorization with a not-to-exceed amount of $15,000.00. Funding is allocated from Project Number LE 807, Organization Code 3704 0100 000, with the full amount charged to Fund Category 131545, Object Code 099001, and Category/Year 101492. This authorization represents a single work task under the indefinite delivery contract vehicle between FDEP/OER and ACT for emergency environmental response services.
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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 2025-4I-73030
LE807 Jason Huffman 8-1-25
CR 579 Jasson Drinkard
2776 CR 579 Wimauma, FL 813-470-5908
Wimauma Hillsborough 813-244-2934
1 1
1 D
15,000.00
LE 807 3704 0100 000 FC 131545 099001 101492 15,000 00
Jasson Drinkard 8-8-25
Michelle Ortiz 08.26.25
Vickie Koenig 10/16/2025
Samuel Graves
Vickie Koenig Digitally signed by Vickie Koenig Date: 2025.10.16 08:39:44 -04'00'
Michelle Ortiz Digitally signed by Michelle Ortiz Date: 2025.08.26 12:03:00 -04'00'
Jasson Drinkard Digitally signed by Jasson Drinkard Date: 2025.08.08 16:46:29 -04'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2025.10.17 08:48:07 -04'00'
File details come from the government source that posted it. Updated .