CN-370000-LE810-4I66543C.pdf
PDF 161 KB Posted
- Contract number
- LE810
- Issued by
- Florida
About this file
This Work Authorization Form (OER_13), effective July 1, 2017, is issued by the Florida Department of Environmental Protection (FDEP) Office of Emergency Response and authorizes emergency response work to be performed by Hull's Environmental under Contract LE810. The authorization pertains to DEP Incident #2020-4I-66543C, dated November 6, 2020, for a used oil spill response in Hillsborough County near 5998 Bridle Path Lane in Tampa. The incident was assigned to Domenic LetoBarone, the On-Scene Coordinator, with Mike Bevacqua representing the contractor.
The work authorization specifies spill response activities involving the removal and remediation of 10 to 15 gallons of used motor oil dumped on county right-of-way. The scope of work includes excavation using a backhoe with long-reach capability, soil remediation, vacuum truck services, transportation of contaminated materials in 55-gallon drums and roll-off containers, and subsequent backfill and sod restoration. The work is assigned a fixed-price amount of $20,000.00 and is funded through Project LE810, Organization Code 37040100000, with funding sourced from Object Code 139900, Fund Category 099001, and allocation number 101492. All required approvals were digitally signed between November 10 and November 20, 2020, by the DEP Representative, Contractor Representative, and OER Budget Representative.
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-66543C
LE810 Mike Bevacqua 11/6/2020
Used oil dumping - Bridle Path Lane - County R.O.W. Domenic LetoBarone
County R.O.W. - near 5998 Bridle Path Lane 813-299-3608
Tampa Hillsborough 813-299-3608
Let's schedule for this week if possible
10 to 15 gallons of used motor oil dumped on County R.O.W.
1 D
Backfill & sod
Please bring the vacuum truck during the excavation. This dig will mostly likely require an excavator with a long reach capability. The angle of the bank may be too steep a platform to work from. The area will need backfill and sod to stabilize the slope and prevent rapid washout.
20,000.00
LE810 37040100000 FC 139900 099001 101492 20000
Domenic LetoBarone 11/10/2020
Mike Bevacqua 11/10/2020
Kristin Gousse 11/20/2020
Melissa Woehle
✔ used oil contaminated soils
Used motor oil on embankment, soil shoulder, and in vegetative waterway
Kristin Gousse Digitally signed by Kristin Gousse Date: 2020.11.20 13:51:20 -05'00'
Michael Bevacqua Digitally signed by Michael Bevacqua Date: 2020.11.12 09:50:15 -05'00'
Domenic LetoBarone Digitally signed by Domenic LetoBarone Date: 2020.11.12 09:56:50 -05'00'
Melissa Woehle Digitally signed by Melissa Woehle Date: 2020.11.19 12:05:40 -05'00'
File details come from the government source that posted it. Updated .