CN-370000-LE811-2I-70811.pdf
PDF 159 KB Posted
- Contract number
- LE811
- Issued by
- Florida
About this file
Work Authorization Summary
This is a Work Authorization Form (OER_13, effective 7-01-2017) issued by the Florida Department of Environmental Protection's Office of Emergency Response for emergency response services. The document involves Cliff Berry, Inc. as the contractor, with the work to be performed at the Reese Abandoned Drum site located at 6220 Reese Road in Davie, Broward County, Florida. The incident occurred on January 31, 2024, with DEP Incident Number 2024-2I-70811. The On-Scene Coordinator is Camren Richter, and the work was authorized by DEP Representative Camren Richter, Contractor Representative William Reasoner, and OER Budget Representative Vickie Koenig.
The scope of work involves response to an abandoned drum (55-gallon) with unknown suspected materials. The level of effort includes one supervisor, one recovery technician, one driver, one response truck, one overpack drum, and two 55-gallon drums. Analytical and disposal arrangements are to be handled via the contractor. The work assignment is structured as a fixed price contract with a not-to-exceed estimate amount of $5,000. Funding is allocated from Project LE811, Organization Code 3704 0100 000, with Object Code 131545, Fund Category 0990001, and Category/Year 102577. All required signatures were obtained between January 31 and February 1, 2024.
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
Cliff Berry, Inc. 2024-2I-70811
LE811 1/31/2024
Reese Abandoned Drum Camren Richter
6220 Reese Rd 561-681-6767
Davie Broward 954-658-4506
Unknown
Driver
LE811 3704 0100 000 FC 131545 0990001 102577 5000 00
Camren Richter 1/31/2024
William Reasoner 1/31/2024
Vickie Koenig 2/1/2024
Samuel Graves
✔ 55-Gallon
Vickie Koenig Digitally signed by Vickie Koenig Date: 2024.02.01 14:05:00 -05'00'
William Reasoner Digitally signed by William Reasoner Date: 2024.01.31 15:28:38 -05'00'
Camren Richter Digitally signed by Camren Richter Date: 2024.01.31 09:33:54 -05'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2024.02.01 13:51:28 -05'00'
File details come from the government source that posted it. Updated .