CN-370000-LE810-4I68510.pdf
PDF 132 KB Posted
- Contract number
- LE810
- Issued by
- Florida
About this file
Work Authorization Form Summary
This is a Work Authorization Form (OER_13, effective July 1, 2017) issued by the Florida Department of Environmental Protection's Office of Emergency Response. The form authorizes work to be performed by Hulls Environmental under Contract #810 in response to DEP Incident #2021-4I-68510. The incident occurred on December 15, 2021, at Williams Road and East Sligh Avenue in Tampa, Hillsborough County, Florida. The On-Scene Coordinator is Trevor Wavelet, with primary contact through Hulls Environmental representative Mike Bevacqua.
The work scope involves spill response and soil removal services addressing the discharge of used motor oil and suspected paints totaling approximately 20 gallons from three abandoned drums. Services include laying absorbent pads and visqueen sheeting over the contaminated area with perimeter caution tape. The level of effort includes one supervisor, two recovery technicians, one equipment operator, and equipment consisting of two 55-gallon drums, a pickup/van, and a backhoe or similar equipment. The work assignment is structured as a fixed-price contract with a not-to-exceed estimate of $3,000. Analytical and disposal arrangements are 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, with $3,000 authorized from Fund Category 099001 for fiscal year 102577.
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
Hulls Environmental 2021-4I-68510
810 Mike Bevacqua 12/15/21
Williams rd & E Sligh ave Oil Dumping Trevor Wavelet
Williams rd & E Sligh ave (813) 470-5946
Tampa Hillsborough (813) 399-0581
Used Motor Oil & Suspected paints - 20 gallons spilled
1 work clothes
Discharge of oil from 3 abandoned drums - (CBI handled drum disposal)
LE 810 37040100000 FC 139900 099001 102577 3000 00
Trevor Wavelet December 16, 2021
Michael Bevacqua December 16, 2021
Amanda Lanphere December 16, 2021
Samuel Graves
Petroleum contaminated soil
Laid absorbent pads and visqueen over the contaminated area - caution tape around the perimeter
Amanda Lanphere Digitally signed by Amanda Lanphere Date: 2021.12.16 13:46:41 -05'00'
Michael Bevacqua Digitally signed by Michael Bevacqua Date: 2021.12.16 11:22:53 -05'00'
Trevor Wavelet Digitally signed by Trevor Wavelet Date: 2021.12.16 10:45:21 -05'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2021.12.16 13:31:16 -05'00'
File details come from the government source that posted it. Updated .