CN-370000-LE811-4I-73206.pdf
PDF 160 KB Posted
- Contract number
- LE811
- Issued by
- Florida
About this file
This is a Work Authorization Form (WAF) issued by the Florida Department of Environmental Protection (FDEP), Office of Emergency Response (OER). The document authorizes work to be performed by Cliff Berry Inc (CBI) under Contract #LE811 in response to DEP Incident #2025-4I-73206 dated October 13, 2025. The incident site is located at 2108 Crosby Road in Valrico, Hillsborough County, Florida. The contracting parties include the FDEP as the authorizing agency, with approval signatures from Jasson Drinkard (DEP Representative), Aiden Tellier (Contractor Representative), and Vickie Koenig (OER Budget Representative).
The work authorization specifies the handling of one abandoned drum containing a white 55-gallon metal drum. The scope of work includes response activities with one supervisor and one recovery technician utilizing a response truck. 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 amount of $1,600.00. Funding is allocated from Project No. LE 811, Organization Code 3704 0100 000, using Object Code 131545, Fund 099001, Category/Year 102577. The authorization was executed on October 13-16, 2025, with all required signatures obtained prior to transmittal to the Finance and Administration department.
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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
Cliff Berry Inc (CBI) 2025-4I-73206
LE811 Aden Tellier 10/13/2025
2108 Crosby Rd Jasson Drinkard
2108 Crosby Rd 813-470-5908
Valrico Hilsborough 813-244-2934
D
White 55gal Metal drum
1600.00
LE 811 3704 0100 000 FL 131545 099001 102577 1,600 00
Jasson Drinkard 10/13/2025
AIDEN TELLIER 10/14/2025
Vickie Koenig 10/16/2025
Samuel Graves
✔ 1
Vickie Koenig Digitally signed by Vickie Koenig Date: 2025.10.16 08:36:57 -04'00'
Aiden Tellier Digitally signed by Aiden Tellier Date: 2025.10.15 14:10:35 -04'00'
Jasson Drinkard Digitally signed by Jasson Drinkard Date: 2025.10.15 16:45:22 -04'00'
Samuel Graves Digitally signed by Samuel Graves Date: 2025.10.16 09:27:11 -04'00'
File details come from the government source that posted it. Updated .