CN-370000-LE810-4I-65628.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 (DEP), Office of Emergency Response, authorizing Hull's Environmental to perform emergency response services related to incident 2020-4I-65628 occurring on May 4, 2020, at the Canal site in Palmetto, Manatee County, Florida. The incident was coordinated by On-Scene Coordinator Jordan Luscier and approved by DEP Representative Jordan Luscier, Contractor Representative Michael Bevacqua, and OER Budget Representative Kristin Gousse on May 11, 13, and 14, 2020, respectively.
The work involves spill response and soil removal services addressing 15 gallons of old gasoline from a motor home that contaminated soil and a canal/drainage ditch with surface water. Hull's Environmental will conduct site inspection, preburn sampling, utility location, and road permit acquisition. Services include disposal of contaminated soil and media, removal of monitoring of traffic (MOT), confirmatory sampling if required, and sod replacement. Equipment deployed includes one supervisor, three recovery technicians, one equipment operator, one response truck, one vacuum truck, one pickup/van, one backhoe, six 55-gallon drums, and two roll-off containers. Analytical and disposal arrangements are managed via the contractor. The work is authorized as a fixed price contract with a not-to-exceed estimate of $15,000, funded through DEP Project Number LE810, Organization Code 37040000222, Fund 780001, and Category/Year 10027.
View the file
Other files
Show 40 more
50 files listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 2020-4I-65628
LE810 Mike Bevacqua 05/04/20
Canal Jordan Luscier
1212 8th St W 813/470-5791
Palmetto Manatee 813/267-3521
Please call cell to coordinate operational date/time.
15 gallons of old gasoline from a motor home. The fuel impacted soil and a canal/drainage ditch with surface water.
3 2
1 work clothes roll-off truck
Hull's will inspect the site, take a preburn sample, have utility locates performed, and complete any required road permits. Hull's will arrange for the following: disposal of the contaminated soil/PCW/media, required MOT, confirmatory sampling if needed, and sod replacement. A vacuum truck will also be used to flush a storm drain and recover any free product from the canal.
15,000
LE810 37040000222 ZC 139900 780001 10027 15000
Jordan Luscier 5/11/20
Michael Bevacqua 5/13/20
Kristin Gousse 5/14/2020
Melissa Woehle
Kristin Gousse Digitally signed by Kristin Gousse Date: 2020.05.14 13:38:15 -04'00'
Michael Bevacqua Digitally signed by Michael Bevacqua Date: 2020.05.13 11:29:40 -04'00'
Jordan Luscier Digitally signed by Jordan Luscier Date: 2020.05.11 12:11:11 -04'00'
Melissa Woehle Digitally signed by Melissa Woehle Date: 2020.05.14 13:57:10 -04'00'
File details come from the government source that posted it. Updated .