CN-370000-LE810-BCESup4.pdf
PDF 134 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, authorizing work to be performed by Hulls Environmental Services, Inc. under Contract LE810. The authorization covers emergency response services at the Blackjack Creek Oil and Gas Wellfield site located southeast of Jay, Florida in Santa Rosa County. The incident (BCE2023) was authorized on November 14, 2025, with oversight provided by On-Scene Coordinator Shanin Speas-Frost.
The work authorization directs Hulls Environmental Services, Inc. to provide disposal services for approximately 35,200 gallons of crude oil recovered from flushing lines around the Black Creek Energy plant. The waste is classified as production oil and will be disposed of via subcontractor arrangements. The work assignment is structured as a fixed-price contract with a not-to-exceed estimate of $65,000. Funding is drawn from Project BJC23, Organization Code 37357030000, Object Code 139900, Fund 780001, Category 088502/20. The authorization was approved and digitally signed by all required parties, including the DEP Representative, Contractor Representative, and Budget Representative, with final approval documented on November 21, 2025.
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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: __________________
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 Services, Inc. BCE2023
LE810 Larry Hall NA
Blackjack Creek Oil and Gas Wellfield (Blackjack Creek) Shanin Speas-Frost southeast of Jay, Florida : (850) 245-8406
Jay Santa Rosa (850) 508-1809 when possible
H2S gases and containment of pollutants/contaminants
Contractor to provide for the disposal of about 35,200 gallons of crude oil recovered from flushing lines around the Black Creek Energy plant.
65,000
BJC23 37357030000 ZJ 139900 780001 088502/20 65,000 00
Shanin Speas-Frost 11/14/2025
Larry Hall 11/14/2025
Keisha Akhavein
Cindy Mulkey production oil
Keisha Akhavein Digitally signed by Keisha Akhavein Date: 2025.11.19 11:35:21 -05'00'
Larry Hall Digitally signed by Larry Hall Date: 2025.11.14 14:27:05 -05'00'
Digitally signed by Shanin Speas-Frost Date: 2025.11.14 14:40:20 -05'00'
Cindy Mulkey Digitally signed by Cindy Mulkey Date: 2025.11.21 13:13:26 -05'00'
4th
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