CN-370000-LE810-4C-66975.pdf
PDF 132 KB Posted
- Contract number
- LE810
- Issued by
- Florida
About this file
This is a Work Authorization Form (OER_13, Effective 7-01-2017) issued by the Florida Department of Environmental Protection (FDEP), Office of Emergency Response (OER). The document authorizes emergency response work under an indefinite delivery contract with Hull's Environmental (Contract #LE810). The authorization was issued on February 6, 2021, for DEP Incident #2021-4C-66975, with On-Scene Coordinator Domenic LetoBarone overseeing the response at 120th Avenue and Lagoon Lane on City property in Treasure Island, Pinellas County, Florida.
The authorized work involves spill response services for approximately 2 gallons of gasoline released from a container on a listing barge grounded against the seawall. Services include transferring fuel from a weathered container into a 55-gallon open-head drum using a drum pump, deploying containment pads and boom around the barge as necessary, and transporting recovered oily water for proper disposal. The work assignment is authorized as a fixed price contract with a not-to-exceed amount of $1,500.00. Funding is provided through Project Number LE810, Organization Code 37040100000, Object Code 139900, Fund Category 099001, and appropriation number 102577. The form was executed and approved by representatives from FDEP, Hull's Environmental, and the OER budget office on February 7, 2021, with final budget approval on February 22, 2021.
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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 2021-4C-66975
LE810 Mike Bevacqua 2/6/2021 sunken barge with fuel spill Domenic LetoBarone
120th Avenue and Lagoon Lane on City property 813-299-3608
Treasure Island Pinellas 813-299-3608
Please respond today
~ 2-gallons of gasoline was released from a container on a listing barge grounded and pinned against the seawall.
Work Clothes
Pads & Boom
Transfer fuel from weathered container into a 55-gallon open-head drum. Deploy pads/boom around barge as necessary. Transport the recovered oily water for proper disposal.
1,500.00
LE810 37040100000 FL 139900 099001 102577 1500
Domenic LetoBarone 2/7/2021
Mike Bevacqua 2/7/2021
Kristin Gousse 2/22/2021
Cory Dewayne Dilmore oily water or PCW
Use drum pump to transfer fuel into a DOT approved container. Deploy pads
Kristin Gousse Digitally signed by Kristin Gousse Date: 2021.02.22 12:43:36 -05'00'
Michael Bevacqua Digitally signed by Michael Bevacqua Date: 2021.02.12 17:56:28 -05'00'
Domenic LetoBarone Digitally signed by Domenic LetoBarone Date: 2021.02.09 09:21:17 -05'00'
Cory Dewayne Dilmore Digitally signed by Cory Dewayne Dilmore Date: 2021.02.17 08:20:52 -05'00'
File details come from the government source that posted it. Updated .