CN-370000-LE811-4C-70122.pdf

This is a Work Authorization Form (WAF) issued by the Florida Department of Environmental Protection (DEP), Office of Emergency Response, dated June 28, 2023. The form authorizes work to be performed by Cliff Berry Inc (CBI), the contractor, under Contract #LEB11. The site is located at 4146 Pine Dale Court in Hernando Beach, Hernando County, Florida. The work is coordinated by DEP Incident #2023-4C-70122, with Jon Belcher serving as the On-Scene Coordinator (OSC) and Jon Sandora as the Contractor Representative.

The authorized work involves response to an abandoned drum containing approximately 100 gallons of fuel bladder gasoline. The work assignment is a fixed-price arrangement not to exceed $180. The level of effort includes one supervisor and one equipment operator from CBI, with drop-off of materials to be conducted by OER Tampa. The funding for this work is charged to Project No. LEB11, Organization Code 27-04D10-0000, Fund 131545, and Category/Year 1625-7A, with an approved amount of $180. The form was executed on June 27, 2023, with approvals from Jon Belcher (DEP Representative), Jon Sandora (Contractor Rep), and Amanda Lanphere (OER Budget Rep), finalized on July 10, 2023.