CN-370000-LE811-3I-69318.pdf
PDF 161 KB Posted
- Contract number
- LE811
- 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 (OER). The document authorizes work under Contract LE811 with CBI as the contractor. The authorization pertains to incident 2022-3I-69318 occurring on August 3, 2022, at John Pennekamp State Park in Key Largo, Monroe County, Florida. Vincent Shanberg serves as the On-Scene Coordinator, with Bill Reasoner as the contractor representative. The work was approved on August 23, 2022, by DEP Representative Vincent Shanberg, Contractor Representative William Reasoner, and OER Budget Representative Amanda Lanphere.
The authorization covers mobilization and transport services for abandoned drums. Specifically, the contractor is tasked with picking up and transporting 15 fifteen-gallon drums (14 containing gasoline and 1 empty) that are currently closed and stabilized for removal and proper disposal at an appropriate treatment, storage, and disposal facility. The work is assigned as a fixed-price contract with a not-to-exceed amount of $2,500. Analytical and disposal arrangements are to be handled via the contractor, with wastes profiled as PCW (Petroleum-Contaminated Waste). Funding is allocated from Project LE811, Organization Code 37040100000, Object Code 139900, Fund Category 099001, with the amount of $2,500 charged to Cost Center 102577.
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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: __________________
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
CBI 2022-3I-69318
LE811 Bill Reasoner 8/3/2022
John Pennekamp State park Vincent Shanberg
102601 Overseas Hwy. 305-289-7071
Key Largo Monroe 305-481-0960
A total of 15 15-gallon drums. 14 of the drums contain gasoline and 1 is empty
Mobilization
Drums are closed and stabilized for pick-up. Mobilize to pick up drums for transport and proper disposal.
LE811 37040100000 FL 139900 099001 102577 2500 00
Vincent Shanberg 8/23/2022
William Reasoner 8/23/2022
Amanda Lanphere 08/23/2022
Samuel Graves
✔ PCW
✔ 15
Amanda Lanphere Digitally signed by Amanda Lanphere Date: 2022.08.23 15:58:29 -04'00'
William Reasoner Digitally signed by William Reasoner Date: 2022.08.23 12:10:43 -04'00'
Vincent Shanberg Digitally signed by Vincent Shanberg Date: 2022.08.23 12:56:56 -04'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2022.08.23 16:08:18 -04'00'
File details come from the government source that posted it. Updated .