CN-370000-LE810-4C-68625.pdf
PDF 131 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), authorizing work to be performed by Hulls Environmental under Contract #810 for incident 2022-4C-68625. The incident, dated January 28, 2022, occurred at the intersection of Coxswain Court and Tower Drive in Hudson, Pasco County, Florida, and involved a hydraulic oil discharge from a barge that was lifted out of the water. The incident was managed by OSC Trevor Wavelet, with DEP Representative Mike Bevacqua and Contractor Representative Mike Bevacqua overseeing the response.
The work authorization specifies two primary tasks: spill response and removal of petroleum-contaminated soil. The scope of work includes one supervisor, two recovery technicians, one equipment operator, one response truck, one backhoe or similar equipment, and five 55-gallon drums for containment. The work is assigned as a fixed-price contract with a not-to-exceed estimate of $3,000. Analytical and disposal arrangements are to be handled via the contractor, with wastes profiled as petroleum-contaminated soil. Funding is allocated from Project No. LE 810, Organization Code 37040100000, Object Code 139900, Fund Category 212001, with authorization code 101492 for the $3,000 amount. The work authorization was approved and signed by all required parties on February 3-8, 2022.
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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
Hulls Environmental 2022-4C-68625
810 Mike Bevacqua 1/28/22
Coxswain ct & Tower dr Oil discharge Trevor Wavelet
Coxswain ct & Tower rd 813-470-5946
Hudson Pasco 813-399-0581
2/3/22
Hydraulic oil
1 Work Clothes
Discharge of hydraulic oil from a barge that was lifted out of the water
LE 810 37040100000 FC 139900 212001 101492 3000 00
Trevor Wavelet 2/3/2022
Mike Bevacqua 2/4/2022
Amanda Lanphere 02/08/2022
Samuel Graves
Petroleum contaminated soil
Removal of petroleum contaminated soil
Amanda Lanphere Digitally signed by Amanda Lanphere Date: 2022.02.08 11:50:32 -05'00'
Michael Bevacqua Digitally signed by Michael Bevacqua Date: 2022.02.04 12:08:21 -05'00'
Trevor Wavelet Digitally signed by Trevor Wavelet Date: 2022.02.03 15:22:57 -05'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2022.02.08 10:03:14 -05'00'
File details come from the government source that posted it. Updated .