CN-370000-LE810-1I-73171.pdf
PDF 122 KB Posted
- Contract number
- LE810
- 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 emergency response services from Hull's Environmental under Contract #LE810 for a diesel spill incident (DEP Incident #2025-11-73171) occurring on September 11, 2025, at I-295 North Bound Mile Marker 51 in Jacksonville, Duval County. The incident was reported by On-Scene Coordinator Donielle McKinley. Key personnel involved include Contractor Representative Larry Hall and DEP Representative Scott Fullerton.
The work authorization covers spill response and soil removal services addressing approximately 30-50 gallons of diesel impacting the soil median. The scope includes one supervisor, two recovery technicians, and one equipment operator utilizing a response truck, pickup or van, and backhoe or similar equipment, along with visqueen, two roll-off containers, work clothes PPE, and MOT. The work is assigned as a fixed-price contract with a not-to-exceed amount of $25,000, to be funded from Project No. LE 810, Organization Code 3704 0100 000, Object Code 131545, and Fund Category 099001 (101492). The remediation is scheduled for nighttime execution due to heavy traffic conditions, with PID readings to be conducted by ERU personnel. All required signatures were obtained between September 24 and October 21, 2025.
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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
Hull's Environmental 2025-1I-73171
LE810 Larry Hall 9-11-2025
Jackson Express Corp Diesel Spill Donielle McKinley
I-295 NB MM 51 904-256-1552
Jacksonville Duval 904-510-2643
30-50 gallons of diesel impacting the soil median on I-295 MM 51
2 2
1 D (Work Clothes)
PID readings to be conducted by ERU personnel. Will have to be a night time remediation due to heavy traffic in this area.
25,000
LE 810 3704 0100 000 FC 131545 099001 101492 25,000 00
Donielle McKinley 9/24/2025
Scott Fullerton 10/20/2025
Vickie Koenig 10/21/2025
Samuel Gravecs
Vickie Koenig Digitally signed by Vickie Koenig Date: 2025.10.21 09:18:05 -04'00'
Scott Fullerton Digitally signed by Scott Fullerton Date: 2025.10.20 14:57:32 -04'00'
Donielle McKinley Digitally signed by Donielle McKinley Date: 2025.09.24 10:04:06 -04'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2025.10.21 09:21:15 -04'00'
File details come from the government source that posted it. Updated .