CN-370000-LE808-4I-69906.pdf
PDF 130 KB Posted
- Contract number
- LE808
- 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), dated March 28, 2023. The form authorizes work under Contract No. LE 808 with AOTC (contractor) for emergency response services related to DEP Incident #2023-41-69906. The incident involves a sunken vessel located at 58 SW Marina Drive, Moore Haven, Glades County, Florida. Key personnel include Sean Lynch (OSC/On-Scene Coordinator), John Lucarelli (contractor representative), and Amanda Lanphere (OER Budget Representative).
The authorized work consists of removal and disposal of approximately 400 gallons of red dye diesel fuel from the vessel. The response effort includes one supervisor, two recovery technicians, and one equipment operator, along with a vacuum truck, absorbent boom, and PPE Level D equipment. The work is assigned on a fixed-price basis with a not-to-exceed estimate amount of $10,000. Analytical and disposal arrangements are to be handled via contractor, with wastes profiled as petroleum contact waters. Funding is provided from Project No. LE808, Organization Code 37040100000, Object Code 131545, Fund Category 099001, with the amount of $10,000.00 charged to funding category 101492. All required signatures from DEP Representative, Contractor Representative, and OER Budget Representative were obtained on March 28, 2023.
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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
AOTC 2023-4I-69906
LE 808 John Lucarelli 3/28/2023
Sunken Vessel Moore Haven Sean Lynch
58 SW Marina Drive 813-470-5925
Moore Haven Glades 813-244-2934
400 gallons of red dye diesel fuel
1 D
Absorbent boom
10,000
LE808 37040100000 FC 131545 099001 101492 10,000 00
Sean Lynch 3/28/2023
John Lucarelli 3/28/2023
Amanda Lanphere 3/28/2023
Samuel Graves
Petroleum contact waters
Removal and disposal of Diesel from Vessel
Amanda Lanphere Digitally signed by Amanda Lanphere Date: 2023.03.28 13:42:20 -04'00'
John Lucarelli Digitally signed by John Lucarelli DN: cn=John Lucarelli, o=AOTC, ou, email=jlucarelli@a-otc.com, c=US Date: 2023.03.28 13:21:48 -04'00'
Sean Lynch Digitally signed by Sean Lynch Date: 2023.03.28 13:29:58 -04'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2023.03.28 13:36:27 -04'00'
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