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NORTHEAST WRF IMPROVEMENTS PROJECT - 19-0029-UT - BOOK 4Book 4 Northeast WRF Improvements Project 19 -0029 -UT Contract Documents & Specifications Section IVc Discharge Monitoring Reports through Section V - Contract 1 DEP NT IPPINIRMINNTAPPINTEcIPPenscillillE Mt RIN ORT T A _ When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: FL0128937-016-D W I P/RM LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: ❑ NO DISCHARGE FROM SITE: 0 MONITORING PERIOD From: Final REPORT FREQUENCY: MA D-001 D001 SURFACE WATER DISCHARGE LOCATION, with Influent PROGRAM: Monthly Domestic To: Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Flow PARM Code 50050 Y Mon. Site No. FLW-02 Sample Measurement Permit Requirement 13.5 (An.Avg.) MGD Continuous Flow Totalizer Flow PARM Code 50050 1 Mon. Site No. FLW-02 Sample Measurement Permit Requirement Report (Mo.Avg.) MGD Continuous Flow Totalizer BOD, Carbonaceous 5 day, 20C PARM Code 80082 Y Mon. Site No. EFA -01 Sample Measurement Permit Requirement 5.0 (An.Avg.) mg/L 5 Days/Week 24 -hr FPC BOD, Carbonaceous 5 day, 20C PARM Code 80082 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 10.0 (Max.) 7.5 (Max.Wk.Avg.) 6.25 (Mo.Avg.) mg/L 5 Days/Week 24 -hr FPC Solids, Total Suspended PARM Code 00530 Y Mon. Site No. EFA -01 Sample Measurement Permit Requirement 5.0 (An.Avg.) mg/L 5 Days/Week 24 -hr FPC Solids, Total Suspended PARM Code 00530 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 10.00 (Max.) 7.5 (Max.Wk.Avg.) 6.25 (Mo.Avg.) mg/L 5 Days/Week 24 -hr FPC I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP D-001 NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Nitrogen, Total PARM Code 00600 Y Mon. Site No. EFA -01 Sample Measurement Permit Requirement 3.0 (An.Avg.) mg/L 5 Days/Week 24 -hr FPC Nitrogen, Total PARM Code 00600 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 6.0 (Max.) 4.5 (Max.Wk.Avg.) 3.75 (Mo.Avg.) mg/L 5 Days/Week 24 -hr FPC Phosphorus, Total (as P) PARM Code 00665 Y Mon. Site No. EFA -01 Sample Measurement Permit Requirement Report (An.Avg.) mg/L 5 Days/Week 24 -hr FPC Phosphorus, Total (as P) PARM Code 00665 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement Report (Max.) Report (Max.Wk.Avg.) Report (Mo.Avg.) mg/L 5 Days/Week 24 -hr FPC Solids, Total Suspended PARM Code 00530 B Mon. Site No. EFB-01 Sample Measurement Permit Requirement 5.0 (Max.) mg/L 5 Days/Week Grab pH PARM Code 00400 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 6.5 (Min.) 8.5 (Max.) s.u. Continuous Meter Coliform, Fecal, % less than detection PARM Code 51005 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 75 (Mo.Min.) percent Monthly Calculated Coliform, Fecal PARM Code 74055 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 25 (Max.) #/100mL 5 Days/Week Grab Chlorine, Total Residual (For Disinfection) PARM Code 50060 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 1.0 (Min.) mg/L Continuous Meter Chlorine, Total Residual (For Dechlorination) PARM Code 50060 1 Mon. Site No. EFD-01 Sample Measurement Permit Requirement 0.01 (Max.) mg/L Daily; 24 hours Grab S EFF11111. DA_ day _nd DE1-62-6 10), F'e No')94 _ 1 MEI MIN _ r MSC1 E M( RIN ORT linr A ( ued) 1 FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: D-001 PERMIT NUMBER: FLO128937-016-DWI P/RM To: Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Enterococci PARM Code 31639 A Mon. Site No. EFA-01Requirement Sample Measurement Permit 35 (Mo.Geo.Mn.) #/100mL Monthly Calculated Enterococci PARM Code 31639 P Mon. Site No. EFA -01 Sample Measurement Permit Requirement 276 (Max.) #/100mL 5/Month Grab Copper, Total Recoverable PARM Code 01119 1 Mon. Site No. EFD-01 Sample Measurement Permit Requirement 3.7 (Max.) mg/L Monthly Grab Dichlorobromomethane PARM Code 32101 Y Mon. Site No. EFD-01 Sample Measurement Permit Requirement 43.0 (An.Avg.) ug/L Monthly Calculated Dichlorobromomethane PARM Code 32101 1 Mon. Site No. EFD-01 Sample Measurement Permit Requirement Report (Max.) ug/L Monthly Grab Oxygen, Dissolved (DO) PARM Code 00300 1 Mon. Site No. EFD-01 Sample Measurement Permit Requirement 5.0 (Min.) mg/L Daily; 24 hours Grab Nitrogen, Total PARM Code 00600 P Mon. Site No. EFA -01 Sample Measurement Permit Requirement Report (Mo.Total) ton/mth Monthly Calculated Nitrogen, Total PARM Code 00600 Q Mon. Site No. EFA -01 Sample Measurement Permit Requirement Report (An.Total) ton/yr Monthly Calculated Nitrogen, Total PARM Code 00600 R Mon. Site No. EFA -01 Sample Measurement Permit Requirement Report (5Yr.Avg.) ton/yr Monthly Calculated 7 -DAY CHRONIC STATRE Ceriodaphnia dubia (Routine) PARM Code TRP3B P Mon. Site No. EFD-01 Sample Measurement Permit Requirement 100 (Min.) percent Quarterly 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP D-001 NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 7 -DAY CHRONIC STATRE Ceriodaphnia dubia (Additional) PARM Code TRP3B Q Mon. Site No. EFD-01 Sample Measurement Permit Requirement 100 (Min.) percent As needed As required by the permit 7 -DAY CHRONIC STATRE Ceriodaphnia dubia (Additional) PARM Code TRP3B R Mon. Site No. EFD-01 Sample Measurement Permit Requirement 100 (Min.) percent As needed As required by the permit 7 -DAY CHRONIC STATRE Pimephales promelas (Routine) PARM Code TRP6C P Mon. Site No. EFD-0 1 Sample Measurement Permit Requirement 100 (Min.) percent Quarterly 24 -hr FPC 7 -DAY CHRONIC STATRE Pimephales promelas (Additional) PARM Code TRP6C Q Mon. Site No. EFD-01 Sample Measurement Permit Requirement 100 (Min.) percent As needed As required by the permit 7 -DAY CHRONIC STATRE Pimephales promelas (Additional) PARM Code TRP6C R Mon. Site No. EFD-01 Sample Measurement Permit Requirement 100 (Min.) percent As needed As required by the permit Flow PARM Code 50050 P Mon. Site No. FLW-1 Sample Measurement Permit Requirement 13.5 (An.Avg.) MGD Continuous Flow Totalizer Flow PARM Code 50050 Q Mon. Site No. FLW-1 Sample Measurement Permit Requirement Report (Mo.Avg.) MGD Continuous Flow Totalizer Percent Capacity, (TMADF/Permitted Capacity) x 100 PARM Code 00180 1 Mon. Site No. FLW-1 Sample Measurement Permit Requirement Report (Mo.Max.) percent Monthly Calculated BOD, Carbonaceous 5 day, 20C (Influent) PARM Code 80082 G Mon. Site No. INF -01 Sample Measurement Permit Requirement Report (Mo.Avg.) mg/L Weekly 24 -hr FPC Solids, Total Suspended (Influent) PARM Code 00530 G Mon. Site No. INF -01 Sample Measurement Permit Requirement Report (Mo.Avg.) mg/L Weekly 24 -hr FPC _ EFFIE." DA' day _td mclowirtive dimpermit_ 1111. um um Eli MI DE1_62-6 10), [111111k No'IMID94 _ 1 1111. 1111111 MIMI DEP NT PRIVIRMINTAMITECIPOISCRIME MARRINMORTINT A When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: FL0128937-016-D W 1 P/RM LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: ❑ NO DISCHARGE FROM SITE: ❑ MONITORING PERIOD From: IMO NM 1 11111 11111 I Final REPORT FREQUENCY: Monthly MA PROGRAM: Domestic R-001 & R-002 RECLAIMED TO THE MRS and/or ADVANCED WATER PURIFICATION PLANT To: Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Flow PARM Code 50050 Y Mon. Site No. FLW-05 Sample Measurement Permit Requirement 12.0 (An.Avg.) MGD Monthly Calculated Flow PARM Code 50050 1 Mon. Site No. FLW-05 Sample Measurement Permit Requirement Report (Mo.Avg.) MGD Continuous Flow Totalizer Flow (to Advanced Water Purification Plant) PARM Code 50050 P Mon. Site No. FLW-06 Sample Measurement Permit Requirement 4.0 (Day.Max.) MGD Monthly Calculated Flow (to Advanced Water Purification Plant) PARM Code 50050 Q Mon. Site No. FLW-06 Sample Measurement Permit Requirement Report (Mo.Avg.) MGD Continuous Flow Totalizer BOD, Carbonaceous 5 day, 20C PARM Code 80082 Y Mon. Site No. EFA -01 Sample Measurement Permit Requirement 20.0 (An.Avg.) mg/L Monthly Calculated BOD, Carbonaceous 5 day, 20C PARM Code 80082 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 60.0 (Max.) 45.0 (Max.Wk.Avg.) 30.0 (Mo.Avg.) mg/L 5 Days/Week 24 -hr FPC I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: R-001 & R-002 To: PERMIT NUMBER: FL0128937-016-DW1P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample I)pe Solids, Total Suspended PARM Code 00530 B Mon. Site No. EFB-01 Sample Measurement Permit Requirement 5.0 (Max.) mg/L 5 Days/Week Grab pH PARM Code 00400 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 6.0 (Min.) 8.5 (Max.) s.u. Continuous Meter Coliform, Fecal, % less than detection PARM Code 51005 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 75 (Mo.Min.) percent Monthly Calculated Coliform, Fecal PARM Code 74055 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 25 ( Max.) #/IoomL 5 Days/Week Grab Chlorine, Total Residual (For Disinfection) PARM Code 50060 A Mon. Site No. EFA -01 Sample Measurement Permit Requirement 1.0 (Min.) tngl Continuous Meter Turbidity PARM Code 00070 B Mon. Site No. EFB-01 Sample Measurement Permit Requirement Report (Max.) NtU Continuous Meter im EFFIE, DAN. day tmnd numowiramtivAimerinimii EN MI DiiMME62-AIM 10), 1111111e No111.94 MIN ! OM )EP NT filltivmdgiNTAI EC ISC E NuIPLINWICRAMIT A _ When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: FL0128937-016-D W 1 P/RM LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: ❑ NO DISCHARGE FROM SITE: ❑ MONITORING PERIOD From: Final MA RMP -B Class B Biosolids To: IMO MI MI MB I REPORT FREQUENCY: Bi -Monthly PROGRAM: Domestic Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Nitrogen, Sludge, Tot, Dry Wt (as N) PARM Code 78470 + Mon. Site No. RMP -B Sample Measurement Permit Requirement Report (Max.) percent Bi -monthly; every 2 months Composite Phosphorus, Sludge, Tot, Dry Wt (as P) PARM Code 78478 + Mon. Site No. RMP -B Sample Measurement Permit Requirement Report (Max.) percent Bi -monthly; every 2 months Composite Potassium, Sludge, Tot, Dry Wt (as K) PARM Code 78472 + Mon. Site No. RMP -B Sample Measurement Permit Requirement Report (Max.) percent Bi -monthly; every 2 months Composite Arsenic Total, Dry Weight, Sludge PARM Code 49565 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 75.0 (Max.) mg/kg Bi -monthly; every 2 months Composite Cadmium, Sludge, Tot, Dry Weight (as Cd) PARM Code 78476 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 85.0 (Max.) mg/kg Bi -monthly; every 2 months Composite Copper, Sludge, Tot, Dry Wt. (as Cu) PARM Code 78475 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 4300.0 (Max.) mg/kg Bi -monthly; every 2 months Composite I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the in formation submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP RMP -B NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Lead, Dry Weight, Sludge PARM Code 78468 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 840.0 (Max) mg/kg every 2 months Composite Mercury, Dry Weight, Sludge PARM Code 78471 + Mon. Site No. RMP -B Sample Measurement Permit Requirement (Max.) mg/kg everyComposite 2 months Molybdenum, Dry Weight, Sludge PARM Code 78465 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 75.0 (Max.) mg/kg everyComposite 2 months Nickel, Dry Weight, Sludge PARM Code 78469 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 420.0mg (Max.) kg o every 2 months Composite Selenium Sludge Solid PARM Code 61518 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 100.0 (Max.) mg/kg everyBComposite 2 months Zinc, Dry Weight, Sludge PARM Code 78467 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 7500.0 (Max.) mg/kg Bi -monthly; every 2 months Composite pH PARM Code 00400 + Mon. Site No. RMP -B Sample Measurement Permit Requirement q (Max.)Report (. s.u. every 2 o 2 months Composite Solids, Total, Sludge, Percent PARM Code 61553 + Mon. Site No. RMP -B Sample Measurement Permit Requirement Report (Max.) percent Bi -monthly; every 2 months Composite Coliform, Fecal PARM Code 74055 + Mon. Site No. RMP -B Sample Measurement Permit Requirement 2000000 (Geo.Mn.) CFU/g Bi -monthly; every 2 months Grab all EFF111111. DAUM day cellind millillowinillitive dillitermill.111 IIIIII ma um 11111111 Mill 111111 DE111.162-6 10), 1 e No1111.94 IIIII 1 elle MIN Ell _ 1011:1EP NT AllivIRSIIINTAMPrEAMILAINE M( RIN ORT I When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: FL0128937-016-D W 1 P/RM LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: ❑ NO DISCHARGE FROM SITE: 0 MONITORING PERIOD From: Final MA RMP -Q Biosolids Quantity To: A_ ME M 1111111 I REPORT FREQUENCY: Monthly PROGRAM: Domestic Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Biosolids Quantity (Transferred) PARM Code B0007 + Mon. Site No. RMP -01 Sample Measurement Permit Requirement Report (Mo.Total) dry tons Monthly Calculated Biosolids Quantity (Landfilled) PARM Code B0008 + Mon. Site No. RMP -02 Sample Measurement Permit Requirement Report (Mo.Total) dry tons Monthly Calculated Biosolids Quantity (Land -Applied) PARM Code B0006 + Mon. Site No. RMP -03 Sample Measurement Permit Requirement Report (Mo.Total) dry tons Monthly Calculated certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate he information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 DEPARTMENT OF ENVIRONMENTAL PROTECTION DISCHARGE MONITORING REPORT - PART A When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: 0 NO DISCHARGE FROM SITE: 0 MONITORING PERIOD From: FL0128937-016-DW I P/RM Final MA PRT -I Influent Pretreatment To: REPORT FREQUENCY: Annually PROGRAM: Domestic Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type pH PARM Code 00400 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (Min.) Report (Max.) s.a Annually Grab Oil and Grease, hexane extr method PARM Code 00552 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/I. Annually Grab Benzene PARM Code 34030 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) UD:- Annually Grab Bromoform PARM Code 32104 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Carbon tetrachloride PARM Code 32102 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/. Annually Grab Chlorobenzene PARM Code 34301 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/t, Annually Grab *FOR THOSE PARAMETERS THAT ARE SAMPLED ANNUALLY, THE MAXIMUM AND AVERAGE CONCENTRATIONS ARE EQUIVALENT AND SHALL BE REPORTED AS SUCH ON THE DMR. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief; true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): M EFFUSE. DAM day _d nilMowill11111tive M M 111111 M M M DEl_62-6M 10), AIM N oWila94 M FACILITY: City of Clearwater Northeast WRF MAIRIN(JRT r A (Maned) IIIIII Mil IIIII S MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-DW1P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample 1) pc Chlorodibromomethane PARM Code 34306 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Chloroethane PARM Code 85811 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 2-chloroethyl vinyl ether (mixed) PARM Code 34576 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Chloroform PARM Code 32106 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Dichlorobromomethane PARM Code 32101 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,2 -dichlorobenzene PARM Code 34536 G Mon. Site No. PRT -I Sample Measurement Permit Requirement q Report (An.Avg.) Report (Max.) ugL Annually Grab 1,3 -dichlorobenzene PARM Code 34566 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,4 -dichlorobenzene PARM Code 34571 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,1-dichloroethane PARM Code 34496 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,2-dichloroethane PARM Code 32103 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -I NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Q'ality or Concentration Units No. Ex. Frequency of Analysis Sample Type 1,1-dichloroethylene PARM Code 34501 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,2-dichloropropane PARM Code 34541 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,3-dichloropropene PARM Code 77163 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Ethylbenzene PARM Code 34371 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Methyl bromide PARM Code 34413 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Methyl chloride PARM Code 34418 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Methylene chloride PARM Code 34423 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1 ,1,2,2 -tetrachloroethane PARM Code 34516 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Tetrachloroethylene PARM Code 34475 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Toluene PARM Code 34010 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab _ EFFIE.. DA_ day (mid En _ DE1_62-6 10), [Me No t94 We am NE mg UM INN IIIIIII =I _ minscAMEmclIPLINAPPORer ilk A ( olued) _ I FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 1,2-trans-dichloroethylene PARM Code 34546 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,1,1 -trichloroethane PARM Code 34506 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,1,2 -trichloroethane PARM Code 34511 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Trichloroethylene PARM Code 39180 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Vinyl chloride PARM Code 39175 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 2 -chlorophenol PARM Code 34586 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4-dichlorophenol PARM Code 34601 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4 -dimethylphenol PARM Code 34606 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC 4,6-dinitro-o-cresol PARM Code 34657 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4-dinitrophenol PARM Code 34616 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-DW 1P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 2-nitrophenol PARM Code 34591 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ugJL Annually 24 -hr FPC 4-nitrophenol PARM Code 34646 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC p -chloro -m -cresol PARM Code 82627 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC Pentachlorophenol PARM Code 39032 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Phenol, Single Compound PARM Code 34694 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4,6 -trichlorophenol PARM Code 34621 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Acenaphthene PARM Code 34205 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Acenaphthylene PARM Code 34200 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Anthracene PARM Code 34220 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Benzidine PARM Code 39120 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC OM EFFIE.. DAMN day (Maid m(1111111owininitive OM NM Mill M DE1.11162-6 10), No1.1.94 MIN 1 IMO MINI MO _ 1111.0ISCAMIE M(RIN(JRT A (Mimed) mued) NM MI _ FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-D W I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Benzo(a)anthracene PARM Code 34526 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Benzo(a)pyrene PARM Code 34247 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Benzo(b)fluoranthene (3,4 -benzo) PARM Code 79531 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Benzo(ghi)perylene PARM Code 34521 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Benzo(k)fluoranthene PARM Code 34242 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC Bis (2-chloroethoxy) methane PARM Code 34278 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC Bis (2-chloroethyl) ether PARM Code 34273 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Bis (2-chloroisopropyl) ether PARM Code 34283 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Bis (2-ethylhexyl) phthalate PARM Code 39100 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4-bromophenyl phenyl ether PARM Code 34636 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -I NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Butyl benzyl phthalate PARM Code 34292 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2-chloronaphthalene PARM Code 34581 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4-chlorophenyl phenyl ether PARM Code 34641 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Chrysene PARM Code 34320 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Dibenzo (a,h) anthracene PARM Code 34556 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 3,3'-dichlorobenzidine PARM Code 34631 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Diethyl phthalate PARM Code 34336 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Dimethyl phthalate PARM Code 34341 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Di -n -butyl phthalate PARM Code 39110 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4-dinitrotoluene PARM Code 34611 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC _ EFFIE. DA11111 day Mild mc_lowinillitive DE111111162-610), 111111 No411S94 _ INN INN Mill MIN MIMI =I _ 111111 11.ISCRIMPE MJRIN ORT ink A (hued) _ 1 FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 2,6-dinitrotoluene PARM Code 34626 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Di-n-octyl phthalate PARM Code 34596 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 1,2-diphenylhydrazine PARM Code 34346 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Fluoranthene PARM Code 34376 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Fluorene PARM Code 34381 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC Hexachlorobenzene PARM Code 39700 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachlorobutadiene PARM Code 39702 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachlorocyclopentadiene PARM Code 34386 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachloroethane PARM Code 34396 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Indeno (1,2,3 -Cd) pyrene PARM Code 34403 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -I NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Isophorone PARM Code 34408 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Naphthalene PARM Code 34696 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Nitrobenzene PARM Code 34447 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC N-nitrosodimethylamine PARM Code 34438 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC N-nitrosodi-n-propylamine PARM Code 34428 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC N-nitrosodiphenylamine PARM Code 34433 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug'L Annually 24 -hr FPC Phenanthrene PARM Code 34461 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Pyrene PARM Code 34469 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 1,2,4-trichlorobenzene PARM Code 34551 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Aldrin PARM Code 39330 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug'L Annually 24 -hr FPC NM EERIE. DAM day tnd mall] 1)1E1162 -6 10), 1111111. No111.94 MN MIN =I _ I MIIISCE M<RIN(ORT Mir A (CdiZ1'Rued) _ FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Alpha-bhc PARM Code 39336 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC B-bhc-beta PARM Code 39338 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Gamma BHC (Lindane) PARM Code 39782 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I, Annually 24 -hr FPC Delta benzene hexachloride PARM Code 34259 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Chlordane (tech mix. and metabolites) PARM Code 39350 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,4' -DDT (p,p'-DDT) PARM Code 39300 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,4' -DDE (p,p'-DDE) PARM Code 39320 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,4' -DDD (p,p'-DDD) PARM Code 39310 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Dieldrin PARM Code 39380 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC A-endosulfan-alpha PARM Code 34361 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -I NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type B-endosulfan-beta PARM Code 34356 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Endosulfan sulfate PARM Code 34351 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Endrin PARM Code 39390 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC Endrin aldehyde PARM Code 34366 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Heptachlor PARM Code 39410 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Heptachlor epoxide PARM Code 39420 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1242 PARM Code 39496 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr 1 P PCB -1254 PARM Code 39504 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1221 PARM Code 39488 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1232 PARM Code 39492 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC DAUM day (Mrd mcMilowirIMItive ME EMI ME ME 11.11 DE11111.62-6 10), FIMeNoillt94 I OM I= IIIIII MI MIN FACILITY: City of Clearwater Northeast WRF 1.111)MSCE MARRINMORT MIT A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I I 111111 1 all I OM To: PERMIT NUMBER: FL0128937-016-DW 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type PCB -1248 PARM Code 39500 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1260 PARM Code 39508 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1016 PARM Code 34671 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Toxaphene PARM Code 39400 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Antimony, Total Recoverable PARM Code 01268 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Arsenic, Total Recoverable PARM Code 00978 G Mon. Site No. PRT -1 Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Beryllium, Total Recoverable PARM Code 00998 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Cadmium, Total Recoverable PARM Code 01113 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Chromium, Total Recoverable PARM Code 01118 G Mon. Site No. PRT -1 Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC Copper, Total Recoverable PARM Code 01119 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -I To: PERMIT NUMBER: FL0128937-016-DW1P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Lead, Total Recoverable PARM Code 01114 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Mercury, Total Recoverable PARM Code 71901 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Nickel, Total Recoverable PARM Code 01074 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Selenium, Total Recoverable PARM Code 00981 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Silver, Total Recoverable PARM Code 01079 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Thallium, Total Recoverable PARM Code 00982 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Zinc, Total Recoverable PARM Code 01094 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Cyanide, Total Recoverable PARM Code 78248 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Phenolic Compounds, Total Recoverable PARM Code 70029 G Mon. Site No. PRT -I Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab all EFFUSIVE DAM day'nd AMowit'tiveermi' gni me me am NE in DE= 62-6= 10), 1=111e No94 111111 8111 11111 INN NEDEpAIPIPEN, VIRt NTAMPTEC ISC•E MIIRIN ORTPT A When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: 0 NO DISCHARGE FROM SITE: 0 MONITORING PERIOD From: FL0128937-016-D W 1 P/RM Final MA PRT -E Effluent Pretreatment To: REPORT FREQUENCY: Annually PROGRAM: Domestic Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type pH PARM Code 00400 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (Min.) Report (Max.) s.u. Annually Grab Oil and Grease, hexane extr method PARM Code 00552 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/L Annually Grab Benzene PARM Code 34030 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Bromoform PARM Code 32104 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Carbon tetrachloride PARM Code 32102 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Chlorobenzene PARM Code 34301 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab *FOR THOSE PARAMETERS THAT ARE SAMPLED ANNUALLY, THE MAXIMUM AND AVERAGE CONCENTRATIONS ARE EQUIVALENT AND SHALL BE REPORTED AS SUCH ON THE DMR. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), EffectiveNov.29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -E NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Chlorodibromomethane PARM Code 34306 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Chloroethane PARM Code 85811 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/1. Annually Grab 2-chloroethyl vinyl ether (mixed) PARM Code 34576 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug 1 Annually Grab Chloroform PARM Code 32106 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually Grab Dichlorobromomethane PARM Code 32101 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug't Annually Grab 1,2 -dichlorobenzene PARM Code 34536 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually Grab 1,3 -dichlorobenzene PARM Code 34566 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) Lig'1- Annual Grab 1,4 -dichlorobenzene PARM Code 34571 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/1. Annually Grab 1 ,1-dichloroethane PARM Code 34496 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug 1 Annually Grab 1,2-dichloroethane PARM Code 32103 I Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually Grab — EFFIIE. DA_ day mind male' NN I\ c rmiSIN INN 11111 11111 — 1)I 1111116:-6 10), !Mc No111111)94 IIIII 1 IMO 1111111 1111111 111111 II. lin 111111iISCE M(RINORT Ink A (Continued) I FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type I,1-dichloroethylene PARM Code 34501 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,2-dichloropropane PARM Code 34541 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,3-dichloropropene PARM Code 77163 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Ethylbenzene PARM Code 34371 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Methyl bromide PARM Code 34413 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Methyl chloride PARM Code 34418 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Methylene chloride PARM Code 34423 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/1. Annually Grab 1,1,2,2 -tetrachloroethane PARM Code 34516 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Tetrachloroethylene PARM Code 34475 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) u6/L Annually Grab Toluene PARM Code 34010 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -E NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FLO 1 2 8937-0 1 6-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 1,2-trans-dichloroethylene PARM Code 34546 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,1,1 -trichloroethane PARM Code 34506 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 1,1,2 -trichloroethane PARM Code 34511 I Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Trichloroethylene PARM Code 39180 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Vinyl chloride PARM Code 39175 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab 2 -chlorophenol PARM Code 34586 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4-dichlorophenol PARM Code 34601 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4 -dimethylphenol PARM Code 34606 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,6-dinitro-o-cresol PARM Code 34657 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2,4-dinitrophenol PARM Code 34616 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC - EFFIE'', DA_ day .id maEllowirallEive DEl_62-6 10), ESNS NoNallE94 _ 1 _ OM all MI 11111 ISCI M RIN ORT I A( oC`nfmued) no EN am min 11.11 lin I FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-DW 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 2-nitrophenol PARM Code 34591 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4-nitrophenol PARM Code 34646 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC p -chloro -m -cresol PARM Code 82627 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/t. Annually 24 -hr FPC Pentachlorophenol PARM Code 39032 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Phenol, Single Compound PARM Code 34694 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug'L Annually 24 -hr FPC 2,4,6 -trichlorophenol PARM Code 34621 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Acenaphthene PARM Code 34205 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC Acenaphthylene PARM Code 34200 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Anthracene PARM Code 34220 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/t. Annually 24 -hr FPC Benzidine PARM Code 39120 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-DW1P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Benzo(a)anthracene PARM Code 34526 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug'I. Annually 24 -hr FPC Benzo(a)pyrene PARM Code 34247 I Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC Benzo(b)fluoranthene (3,4 -benzo) PARM Code 79531 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug 1. Annual 24 -hr FPC' Benzo(ghi)perylene PARM Code 34521 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/l. Annually 24 -hr FI'C Benzo(k)fluoranthene PARM Code 34242 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug'I- Annually 24 -hr FPC Bis (2-chloroethoxy) methane PARM Code 34278 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/1_ Annually 24 -hr FPC Bis (2-chloroethyl) ether PARM Code 34273 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug1- Annually 24 -hr FPC Bis (2-chloroisopropyl) ether PARM Code 34283 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I_ Annually 24 -hr NPC Bis (2-ethylhexyl) phthalate PARM Code 39100 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) tigi- Annually 24 -hr FPC 4-bromophenyl phenyl ether PARM Code 34636 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC —EFFIE. DA'day impd mImo owie douse rmNEN 1.11 1110 NS 11111 1111 111111 DI]1..162-6111), 0,11.1194 — 11111 — 111111foscjIMIEMCRIIN()RT A (Med) mued) — 11111 MINI En 11111 MI I FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Butyl benzyl phthalate PARM Code 34292 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 2-chloronaphthalene PARM Code 34581 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4-chlorophenyl phenyl ether PARM Code 34641 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Chrysene PARM Code 34320 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Dibenzo (a,h) anthracene PARM Code 34556 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 3,3'-dichlorobenzidine PARM Code 34631 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Diethyl phthalate PARM Code 34336 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr PPC Dimethyl phthalate PARM Code 34341 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Di -n -butyl phthalate PARM Code 39110 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC 2,4-dinitrotoluene PARM Code 34611 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -E NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-DWIP/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type 2,6-dinitrotoluene PARM Code 34626 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Di-n-octyl phthalate PARM Code 34596 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 1,2-diphenylhydrazine PARM Code 34346 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Fluoranthene PARM Code 34376 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Fluorene PARM Code 34381 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachlorobenzene PARM Code 39700 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachlorobutadiene PARM Code 39702 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachlorocyclopentadiene PARM Code 34386 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Hexachloroethane PARM Code 34396 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Indeno (1,2,3 -Cd) pyrene PARM Code 34403 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC -EFFI DA"_day Amu mcanowinionive daniermitaim um am am gm DEFEN.62-621.00), FMINovi94 11111111 "II - ! MRINtRT INF A (Wed) M — FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Isophorone PARM Code 34408 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Naphthalene PARM Code 34696 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Nitrobenzene PARM Code 34447 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/t. Annually 24 -hr PPC N-nitrosodimethylamine PARM Code 34438 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC N-nitrosodi-n-propylamine PARM Code 34428 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC N-nitrosodiphenylamine PARM Code 34433 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Phenanthrene PARM Code 34461 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/l. Annually 24 -hr FPC Pyrene PARM Code 34469 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 1,2,4-trichlorobenzene PARM Code 34551 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/I. Annually 24 -hr FPC Aldrin PARM Code 39330 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FLO 128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Alpha-bhc PARM Code 39336 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC B-bhc-beta PARM Code 39338 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Gamma BHC (Lindane) PARM Code 39782 I Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Delta benzene hexachloride PARM Code 34259 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Chlordane (tech mix. and metabolites) PARM Code 39350 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,4' -DDT (p,p'-DDT) PARM Code 39300 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,4' -DDE (p,p'-DDE) PARM Code 39320 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC 4,4' -DDD (p,p'-DDD) PARM Code 39310 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Dieldrin PARM Code 39380 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC A-endosulfan-alpha PARM Code 34361 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC an EFFIE., DAUM day alind donsermite ISM MI INN 111111 111111 1111111 DE1al1162-6 10), 1 No111111194 MB I II• - gm MSC M RIN(JRT RN A (Milted) 11111 all lila I FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type B-endosulfan-beta PARM Code 34356 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/1. Annually 24 -hr FPC Endosulfan sulfate PARM Code 34351 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Endrin PARM Code 39390 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Endrin aldehyde PARM Code 34366 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Heptachlor PARM Code 39410 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Heptachlor epoxide PARM Code 39420 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1242 PARM Code 39496 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr PPC PCB -1254 PARM Code 39504 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1221 PARM Code 39488 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/t, Annually 24 -hr FPC PCB -1232 PARM Code 39492 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP PRT -E NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type PCB -1248 PARM Code 39500 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1260 PARM Code 39508 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC PCB -1016 PARM Code 34671 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Toxaphene PARM Code 39400 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Antimony, Total Recoverable PARM Code 01268 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Arsenic, Total Recoverable PARM Code 00978 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ugi Annually 24 -hr FPC Beryllium, Total Recoverable PARM Code 00998 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Cadmium, Total Recoverable PARM Code 01113 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Chromium, Total Recoverable PARM Code 01118 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/l. Annually 24 -hr FPC Copper, Total Recoverable PARM Code 01119 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC EFFIE DAUM day inlrd DE11111162-6 10), F Noll11194 111111 _ 1111111 INN II. i M(RIN(JRT Riir A (MIlifued) — MI Mill IIIIII 11111 _ FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -E To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Lead, Total Recoverable PARM Code 01114 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Mercury, Total Recoverable PARM Code 71901 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Nickel, Total Recoverable PARM Code 01074 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Selenium, Total Recoverable PARM Code 00981 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/1. Annually 24 -hr FPC Silver, Total Recoverable PARM Code 01079 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Thallium, Total Recoverable PARM Code 00982 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Zinc, Total Recoverable PARM Code 01094 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually 24 -hr FPC Cyanide, Total Recoverable PARM Code 78248 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab Phenolic Compounds, Total Recoverable PARM Code 70029 1 Mon. Site No. PRT -E Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) ug/L Annually Grab DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit DEP Form 62-620.910(10), Effective Nov. 29, 1994 DEPARTMENT OF ENVIRONMENTAL PROTECTION DISCHARGE MONITORING REPORT - PART A When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: ❑ NO DISCHARGE FROM SITE: ❑ MONITORING PERIOD From: FL0128937-016-DW I P/RM Final MA PRT -R Residuals Pretreatment To: REPORT FREQUENCY: Annually PROGRAM: Domestic Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Arsenic Total, Dry Weight, Sludge PARM Code 49565 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Cadmium, Sludge, Tot. Dry Wt. (Cd) PARM Code 78476 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Copper, Sludge, Tot, Dry Wt. (as Cu) PARM Code 78475 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Lead, Dry Weight PARM Code 78468 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Mercury, Dry Weight PARM Code 78471 + Mon. Site No. PRT -R Sample Measurement ' Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Molybdenum, Dry Weight PARM Code 78465 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite *FOR THOSE PARAMETERS THAT ARE SAMPLED ANNUALLY, THE MAXIMUM AND AVERAGE CONCENTRATIONS ARE EQUIVALENT AND SHALL BE REPORTED AS SUCH ON THE DMR. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): EFFIllir DAM day INV 1E11 IMO 111111 DEII111162-6 10), ANS No11.194 — MI r FACILITY: — SIM MCRING RT A (C ed) all 111111 011 — City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: PRT -R lo: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Nickel, Dry Weight PARM Code 78469 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Selenium Sludge Solid PARM Code 61518 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite Zinc, Dry Weight PARM Code 78467 + Mon. Site No. PRT -R Sample Measurement Permit Requirement Report (An.Avg.) Report (Max.) mg/kg Annually Composite DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 DEPARTMENT OF ENVIRONMENTAL PROTECTION DISCHARGE MONITORING REPORT - PART A When Completed submit this report to: http://www.fldepportal.com/go/ PERMITTEE NAME: MAILING ADDRESS: FACILITY: LOCATION: COUNTY: OFFICE: City of Clearwater Public Utilities Department 1650 North Arcturas Ave. Building C Clearwater, Florida 33765-1945 City of Clearwater Northeast WRF 3290 SR 580 Clearwater, FL 34695 Pinellas Southwest District PERMIT NUMBER: FL0128937-016-DW1P/RM LIMIT: CLASS SIZE: MONITORING GROUP NUMBER: MONITORING GROUP DESCRIPTION: RE -SUBMITTED DMR: ❑ NO DISCHARGE FROM SITE: ❑ MONITORING NOT REQUIRED:* 0 MONITORING PERIOD From: Final MA RWS-A Annual Reclaimed Water or Effluent Analysis REPORT FREQUENCY: Annually PROGRAM: Domestic To: Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Antimony, Total Recoverable (GWS = 6)** PARM Code 01268 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Arsenic, Total Recoverable (GWS = 10) PARM Code 00978 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Barium, Total Recoverable (GWS = 2,000) PARM Code 01009 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Beryllium, Total Recoverable (GWS = 4) PARM Code 00998 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Cadmium, Total Recoverable (GWS = 5) PARM Code 01113 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Chromium, Total Recoverable (GWS =100) PARM Code 01118 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC *THE "MONITOR NG NOT REQUIRED" CHECKBOX SHOULD BE SELECTED WHEN A CERTIFICATION STATEMENT IN ACCORDANCE WITH SUBSECTION 62-600.680(2), F.A.C., IS SUBMITTED WITH THIS DMR. SEE CERTIFICATION STATEMENT IN COMMENTS SECTION BELOW. **GROUND WATER STANDARD (GWS) FOR REFERENCE AND REVIEW ONLY. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. NAME/TITLE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT SIGNATURE OF PRINCIPAL EXECUTIVE OFFICER OR AUTHORIZED AGENT TELEPHONE NO DATE (mm/dd/yyyy) COMMENT AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here): 0 NO NEW NON-DOMESTIC WASTEWATER DISCHARGERS HAVE BEEN ADDED TO THE COLLECTION SYSTEM SINCE THE LAST RECLAIMED WATER OR EFFLUENT ANALYSIS WAS CONDUCTED. SIGN AND DATE: SIMIEFF1111. DAMN day OW mins owinallkive daulermit— DEP_62-62INIB 0), Fang Nov111.94 111111 1111111 111111 _ MN 111111 11111 111111 1111iisarnik moliNkINMIRTA (Med) mued) FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: RWS-A To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Cyanide, Free (amen. to chlorination)(GWS = 200) PARM Code 00722 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Fluoride, Total (as F) (GWS = 4.0/2.0) PARM Code 00951 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Lead, Total Recoverable (GWS = 15) PARM Code 01114 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Mercury, Total Recoverable (GWS = 2) PARM Code 71901 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Nickel, Total Recoverable (GWS = 100) PARM Code 01074 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Nitrogen, Nitrate, Total (as N) (GWS = 10) PARM Code 00620 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Nitrogen, Nitrite, Total (as N) (GWS= 1) PARM Code 00615 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Nitrite plus Nitrate, Total 1 det. (as N)(GWS = 10) PARM Code 00630 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Selenium, Total Recoverable (GWS =50) PARM Code 00981 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Sodium, Total Recoverable (GWS= 160) PARM Code 00923 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: RWS-A To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Thallium, Total Recoverable (GWS = 2) PARM Code 00982 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC 1,1-dichloroethylene (GWS = 7) PARM Code 34501 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,1,1 -trichloroethane (GWS = 200) PARM Code 34506 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,1,2 -trichloroethane (GWS = 5) PARM Code 34511 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,2-dichloroethane (GWS = 3) PARM Code 32103 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,2-dichloropropane (GWS = 5) PARM Code 34541 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,2,4-trichlorobenzene (GWS = 70) PARM Code 34551 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Benzene (GWS = 1) PARM Code 34030 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Carbon tetrachloride (GWS = 3) PARM Code 32102 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Cis-1,2-dichloroethene (GWS = 70) PARM Code 81686 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab ingiEFFF1' DAMINday ogled mo—owiniEllive dalliermitM 111111 sin_ DEF 2-62111111 0), Ella N ov-94 — 11111 111111 1111 11111 ' 1111Csafila M(RIN(JRT I. A ( on toed) — FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: RWS-A To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Dichloromethane (methylene chloride)(GWS = 5) PARM Code 03821 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Ethylbenzene (GWS = 700) PARM Code 34371 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Monochlorobenzene (GWS= 100) PARM Code 34031 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,2 -dichlorobenzene (GWS = 600) PARM Code 34536 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,4 -dichlorobenzene (GWS = 75) PARM Code 34571 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Styrene, Total (GWS = 100) PARM Code 77128 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Tetrachloroethylene (GWS = 3) PARM Code 34475 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Toluene (GWS = 1,000) PARM Code 34010 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab 1,2-trans-dichloroethylene (GWS = 100) PARM Code 34546 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Trichloroethylene (GWS = 3) PARM Code 39180 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP NUMBER: MONITORING PERIOD From: RWS-A To: PERMIT NUMBER: FL0128937-016-DW I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Tr pe Vinyl chloride (GWS= 1) PARM Code 39175 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug 1. Annually Grab Xylenes (GWS = 10,000) PARM Code 81551 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/l. Annually Grab 2,3,7,8-tetrachlorodibenzo-p- dioxin(GWS = 3x10^-5) PARM Code 34675 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/I, Annually 24 -hr FPC 2,4-dichlorophenoxyacetic acid (GWS = 70) PARM Code 39730 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug 1 Annually 24 -hr FPC Silvex (GWS = 50) PARM Code 39760 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug;L Annually 24 -lir FPC Alachlor (GWS = 2) PARM Code 39161 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/I - Annually 24 -hr FPC Atrazine (GWS = 3) PARM Code39033 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ii -1 Annually 24 -lir FPC Benzo(a)pyrene (GWS = 0.2) PARM Code 34247 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/i. Annually 24 -hr FPC Carbofuran (GWS = 40) PARM Code 81405 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Chlordane (tech mix. and metabolites)(GWS = 2) PARM Code 39350 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC In EFFI DA= day clialltd DE.11162-6210), 111111111No.1.94 — NIB INN — FACILITY: — alliMSCONE M RIN RT glitf A (Milted) IIIIII City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: RWS-A To: PERMIT NUMBER: FL0128937-016-D W I P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Dalapon (GWS = 200) PARM Code 38432 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Bis(2-ethylhexyl)adipate (GWS = 400) PARM Code 77903 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Bis (2-ethylhexyl) phthalate (GWS = 6) PARM Code 39100 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Dibromochloropropane (DBCP) (GWS = 0.2) PARM Code 82625 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Dinoseb (GWS = 7) PARM Code 30191 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Diquat (GWS = 20) PARM Code 04443 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Endothall (GWS = 100) PARM Code 38926 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Endrin (GWS = 2) PARM Code 39390 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Ethylene dibromide (1,2- dibromoethane)(GWS = 0.02) PARM Code 77651 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually Grab Glyphosate (GWS = 0.7) PARM Code 79743 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP RWS-A NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-D W 1 P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Heptachlor (GWS = 0.4) PARM Code 39410 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Heptachlor epoxide (GWS = 0.2) PARM Code 39420 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Hexachlorobenzene (GWS= 1) PARM Code 39700 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Hexachlorocyclopentadiene (GWS = 50) PARM Code 34386 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Gamma BHC (Lindane) (GWS = 0.2) PARM Code 39782 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Methoxychlor (GWS = 40) PARM Code 39480 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Oxamyl (vydate) (GWS = 200) PARM Code 38865 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Pentachlorophenol (GWS = 1) PARM Code 39032 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Picloram (GWS = 500) PARM Code 39720 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Polychlorinated Biphenyls (PCBs)(GWS = 0.5) PARM Code 39516 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC INS EFF11111111E DANIS day 11111111nd m111111111lowiritive 41111111.41111111 MN 1111 MN ale NIB NIB DE1111111162-6 10), 41111111 N.11111194 11111 — 1111111 11110 MN 1111116SCIiE MI RIN!RT ink A ( o ued) 1111111 1111111 MIMI I FACILITY: City of Clearwater Northeast WRF MONITORING GROUP NUMBER: MONITORING PERIOD From: RWS-A To: PERMIT NUMBER: FL0128937-016-DWIP/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Simazine (GWS = 4) PARM Code 39055 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Toxaphene (GWS = 3) PARM Code 39400 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Trihalomethane, Total by summation(GWS = 0.080) PARM Code 82080 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually Grab Radium 226 + Radium 228, Total (GWS = 5) PARM Code 11503 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) pCi/L Annually 24 -hr FPC Alpha, Gross Particle Activity (GWS = 15) PARM Code 80045 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) pCi/L Annually 24 -hr FPC Aluminum, Total Recoverable (GWS = 0.2) PARM Code 01104 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Chloride (as C1) (GWS = 250) PARM Code 00940 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Iron, Total Recoverable (GWS = 0.3) PARM Code 00980 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg/L Annually 24 -hr FPC Copper, Total Recoverable (GWS = 1,000) PARM Code 01119 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC Manganese, Total Recoverable (GWS = 50) PARM Code 11123 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annually 24 -hr FPC DMR EFFECTIVE DATE: 1st day of the 2nd month following effective date of permit - DEP Form 62-620.910(10), Effective Nov. 29, 1994 FACILITY: City of Clearwater Northeast WRF DISCHARGE MONITORING REPORT - PART A (Continued) MONITORING GROUP RWS-A NUMBER: MONITORING PERIOD From: To: PERMIT NUMBER: FL0128937-016-DW1P/RM Parameter Quantity or Loading Units Quality or Concentration Units No. Ex. Frequency of Analysis Sample Type Silver, Total Recoverable (GWS = 100) PARM Code 01079 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug, I. Annually 24 -hr FPC Sulfate, Total (GWS = 250) PARM Code 00945 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) me L Annually 24 -hr I PC Zinc, Total Recoverable (GWS = 5,000) PARM Code 01094 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) ug/L Annuall 24 -hr I PC pH (GWS = 6.5-8.5) PARM Code 00400 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) s.u. Annually Grab Solids, Total Dissolved (TDS) (GWS = 500) PARM Code 70295 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg). Annually 24 -hr FPC Foaming Agents (GWS = 0.5) PARM Code 01288 P Mon. Site No. RWS-A Sample Measurement Permit Requirement Report (Max.) mg, L Annually 24 -hr I PC 1111111 ITE E DAMN. ;nSIN lox\ 111111111 11111 I)1:162-6 11111111 10), l_e No\`)9-) 111111 1 DAILY SAMPLE RESULTS - PART B Permit Number: FLO128937-016-DW1P/RM Facility: City of Clearwater Northeast WRF Monitoring Period From: To: PLANT STAFFING: Day Shift Operator Class: Evening Shift Operator Class: 'Night Shift Operator Class: Lead Operator Class: 1 Certificate No: Certificate No: Certificate No: Certificate No: Name: Name: Name: Name: DEP Form 62-620.910(10), Effective Nov. 29, 1994 BOD, Carbonaceou s 5 day, 20C mg/L Chlorine, Total Residual (For Disinfection) mg/L Coliform, Fecal #/100mL Enterococci #/100mL Nitrogen, Total mg/L Phosphorus, Total (as P) mg/L Solids, Total Suspended mg/I, pH (minimum) s.u. pH (maximum) s.u. Solids, Total Suspended mg/L Turbidity N'Ill Code 80082 EFA -01 50060 EFA -01 74055 EFA -01 31639 FFA -01 00600 ITA -01 00665 EFA -01 00530 ITA -01 00400 EFA -01 00400 EFA -01 00530 EFB-01 00070 LTB -01 Mon. Site I 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Total Mo. Avg. PLANT STAFFING: Day Shift Operator Class: Evening Shift Operator Class: 'Night Shift Operator Class: Lead Operator Class: 1 Certificate No: Certificate No: Certificate No: Certificate No: Name: Name: Name: Name: DEP Form 62-620.910(10), Effective Nov. 29, 1994 DAILY SAMPLE RESULTS - PART B Permit Number: FLO128937-016-DW1P/RM Facility: City of Clearwater Northeast WRF Monitoring Period From: To: Chlorine, Total Residual (For Dechlorinatio n) mg/I, Copper, Total Recoverable mg/L Dichlorobro momethane ug/L Oxygen, Dissolved (DO) mg/L Flow MGD Flow MGD Flow MGD Flow MGD Flow MGD Flow MGD BOD, Carbonaceou s 5 day, 20C (Influent) mg/L Code 50060 EFD-01 01119 EFD-01 32101 EFD-01 00300 EFD-01 50050 FLW-1 50050 FLW-02 50050 FLW-03 50050 FLW-04 50050 FL,W-05 50050 FLW-06 80082 INF -01 Mon. Site 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Total Mo. Avg. PLANT STAFFING: Day Shift Operator Class: Evening Shift Operator Class: Night Shift Operator Class: Lead Operator Class: Certificate No: Certificate No: Certificate No: Certificate No: Name: Name: Name: Name: 1 1 1 1 1 1 1 1 1 1 1 1 1 1 DEP Form 62-620.910(10), Effective Nov. 29, 1994 1 DAILY SAMPLE RESULTS - PART B Permit Number: FL0128937-016-DW1P/RM Facility: City of Clearwater Northeast WRF Monitoring Period From: To: ■ Solids, Total Suspended (Influent) mg/L Biosolids Temperature Degrees C (Min) Biosolids Treatment Time Days (Min) Code 00530 INF -01 RMP -B3 RMP -B2 Mon. Site 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 I 22 23 I 24 25 26 27 28 29 30 31 Total o. Avg. PLANT STAFFING: D ay Shift Operator Class: E▪ vening Shift Operator Class: Night Shift Operator Class: ILead Operator Class: 1 Certificate No: Certificate No: Certificate No: Certificate No: Name: Name: Name: Name: DEP Form 62-620.910(10), Effective Nov. 29, 1994 INSTRUCTIONS FOR COMPLETING THE WASTEWATER DISCHARGE MONITORING REPORT Read these instructions before completing the DMR. Hard copies and/or electronic copies of the required parts of the DMR were provided with the permit. All required information shall be completed in full and typed or printed in ink. A signed, original DMR shall be mailed to the address printed on the DMR by the 28th of the month following the monitoring period. Facilities who submit their DMR(s) electronically through eDMR do not need to submit a hardcopy DMR. The DMR shall not be submitted before the end of the monitoring period. The DMR consists of three parts --A, B, and D --all of which may or may not be applicable to every facility. Facilities may have one or more Part A's for reporting effluent or reclaimed water data. All domestic wastewater facilities will have a Part B for reporting daily sample results. Part D is used for reporting ground water monitoring well data. When results are not available, the following codes should be used on parts A and D of the DMR and an explanation provided where appropriate. Note: Codes used on Part B for raw data are different. CODE DESCRIPTION/INSTRUCTIONS ANC DRY FLD IFS LS MNR Analysis not conducted. Dry Well Flood disaster. Insufficient flow for sampling. Lost sample. Monitoring not required this period. CODE DESCRIPTION/INSTRUCTIONS NOD OPS OTH SEF No discharge from/to site. Operations were shutdown so no sample could be taken. Other. Please enter an explanation of why monitoring data were not available. Sampling equipment failure. When reporting analytical results that fall below a laboratory's reported method detection limits or practical quantification limits, the following instructions should be used, unless indicated otherwise in the permit or on the DMR: 1. Results greater than or equal to the PQL shall be reported as the measured quantity. 2. Results less than the PQL and greater than or equal to the MDL shall be reported as the laboratory's MDL value. These values shall be deemed equal to the MDL when necessary to calculate an average for that parameter and when determining compliance with permit limits. 3. Results less than the MDL shall be reported by entering a less than sign ("<") followed by the laboratory's MDL value, e.g. < 0.001. A value of one-half the MDL or one-half the effluent limit, whichever is lower, shall be used for that sample when necessary to calculate an average for that parameter. Values less than the MDL are considered to demonstrate compliance with an effluent limitation. PART A -DISCHARGE MONITORING REPORT (DMR) Part A of the DMR is comprised of one or more sections, each having its own header information. Facility information is preprinted in the header as well as the monitoring group number, whether the limits and monitoring requirements are interim or final, and the required submittal frequency (e.g. monthly, annually, quarterly, etc.). Submit Part A based on the required reporting frequency in the header and the instructions shown in the permit. The following should be completed by the permittee or authorized representative: Resubmitted DMR: Check this box if this DMR is being re -submitted because there was information missing from or information that needed correction on a previously submitted DMR. The information that is being revised should be clearly noted on the re -submitted DMR (e.g. highlight, circle, etc.) No Discharge From Site: Check this box if no discharge occurs and, as a result, there are no data or codes to be entered for all of the parameters on the DMR for the entire monitoring group number; however, if the monitoring group includes other monitoring locations (e.g., influent sampling), the "NOD" code should be used to individually denote those parameters for which there was no discharge. Monitoring Period: Enter the month, day, and year for the first and last day of the monitoring period (i.e. the month, the quarter, the year, etc.) during which the data on this report were collected and analyzed. Sample Measurement: Before filling in sample measurements in the table, check to see that the data collected correspond to the limit indicated on the DMR (i.e. interim or final) and that the data correspond to the monitoring group number in the header. Enter the data or calculated results for each parameter on this row in the non -shaded area above the limit. Be sure the result being entered corresponds to the appropriate statistical base code (e.g. annual average, monthly average, single sample maximum, etc.) and units. Data qualifier codes are not to be reported on Part A. No. Ex.: Enter the number of sample measurements during the monitoring period that exceeded the permit limit for each parameter in the non -shaded area. If none, enter zero. Frequency of Analysis: The shaded areas in this column contain the minimum number of times the measurement is required to be made according to the permit. Enter the actual number of times the measurement was made in the space above the shaded area. Sample Type: The shaded areas in this column contain the type of sample (e.g. grab, composite, continuous) required by the permit. Enter the actual sample type that was taken in the space above the shaded area. Signature: This report must be signed in accordance with Rule 62-620.305, F.A.C. Type or print the name and title of the signing official. Include the telephone number where the official may be reached in the event there are questions concerning this report. Enter the date when the report is signed. Comment and Explanation of Any Violations: Use this area to explain any exceedances, any upset or by-pass events, or other items which require explanation. If more space is needed, reference all attachments in this area. MIN 11111 111111 ` MINI 1111 NM 111111 111111 1111 11111 EN 1111 Forn1111113-9101111111ffectialli 29, 1ale INN I - rB-isAI REs) NM NIB 11111 11111 NO NMI en SIM Mil NM 1E11 1E1 1 Monitoring Period: Enter the month, day, and year for the first and last day of the monitoring period (i.e. the month, the quarter, the year, etc.) during which the data on this report were collected and analyzed. Daily Monitoring Results: Transfer all analytical data from your facility's laboratory or a contract laboratory's data sheets for all day(s) that samples were collected. Record the data in the units indicated. Table 1 in Chapter 62-160, F.A.C., contains a complete list of all the data qualifier codes that your laboratory may use when reporting analytical results. However, when transferring numerical results onto Part B of the DMR, only the following data qualifier codes should be used and an explanation provided where appropriate. CODE DESCRIPTION/INSTRUCTIONS < The compound was analyzed for but not detected. A Value reported is the mean (average) of two or more determinations. J Estimated value, value not accurate. Q Sample held beyond the actual holding time. Y Laboratory analysis was from an unpreserved or improperly preserved sample. To calculate the monthly average, add each reported value to get a total. For flow, divide this total by the number of days in the month. For all other parameters, divide the total by the number of observations. Plant Staffing: List the name, certificate number, and class of all state certified operators operating the facility during the monitoring period. Use additional sheets as necessary. PART D - GROUND WATER MONITORING REPORT Monitoring Period: Enter the month, day, and year for the first and last day of the monitoring period (i.e. the month, the quarter, the year, etc.) during which the data on this report were collected and analyzed. Date Sample Obtained: Enter the date the sample was taken. Also, check whether or not the well was purged before sampling. Time Sample Obtained: Enter the time the sample was taken. Sample Measurement: Record the results of the analysis. If the result was below the minimum detection limit, indicate that. Data qualifier codes are not to be reported on Part D. Detection Limits: Record the detection limits of the analytical methods used. Analysis Method: Indicate the analytical method used. Record the method number from Chapter 62-160 or Chapter 62-601, F.A.C., or from other sources. Sampling Equipment Used: Indicate the procedure used to collect the sample (e.g. airlift, bucket/bailer, centrifugal pump, etc.) Samples Filtered: Indicate whether the sample obtained was filtered by laboratory (L), filtered in field (F), or unfiltered (N). Signature: This report must be signed in accordance with Rule 62-620.305, F.A.C. Type or print the name and title of the signing official. Include the telephone number where the official may be reached in the event there are questions concerning this report. Enter the date when the report is signed. Comments and Explanation: Use this space to make any comments on or explanations of results that are unexpected. If more space is needed, reference all attachments in this area. SPECIAL INSTRUCTIONS FOR LIMITED WET WEATHER DISCHARGES Flow (Limited Wet Weather Discharge): Enter the measured average flow rate during the period of discharge or divide gallons discharged by duration of discharge (converted into days). Record in million gallons per day (MGD). Flow (Upstream): Enter the average flow rate in the receiving stream upstream from the point of discharge for the period of discharge. The average flow rate can be calculated based on two measurements; one made at the start and one made at the end of the discharge period. Measurements are to be made at the upstream gauging station described in the permit. Actual Stream Dilution Ratio: To calculate the Actual Stream Dilution Ratio, divide the average upstream flow rate by the average discharge flow rate. Enter the Actual Stream Dilution Ratio accurate to the nearest 0.1. No. of Days the SDF > Stream Dilution Ratio: For each day of discharge, compare the minimum Stream Dilution Factor (SDF) from the permit to the calculated Stream Dilution Ratio. On Part B of the DMR, enter an asterisk (*) if the SDF is greater than the Stream Dilution Ratio on any day of discharge. On Part A of the DMR, add up the days with an "*" and record the total number of days the Stream Dilution Factor was greater than the Stream Dilution Ratio. CBOD5: Enter the average CBOD5 of the reclaimed water discharged during the period shown in duration of discharge. TKN: Enter the average TKN of the reclaimed water discharged during the period shown in duration of discharge. Actual Rainfall: Enter the actual rainfall for each day on Part B. Enter the actual cumulative rainfall to date for this calendar year and the actual total monthly rainfall on Part A. The cumulative rainfall to date for this calendar year is the total amount of rain, in inches, that has been recorded since January 1 of the current year through the month for which this DMR contains data. Rainfall During Average Rainfall Year: On Part A, enter the total monthly rainfall during the average rainfall year and the cumulative rainfall for the average rainfall year. The cumulative rainfall for the average rainfall year is the amount of rain, in inches, which fell during the average rainfall year from January through the month for which this DMR contains data. No. of Days LWWD Activated During Calendar Year: Enter the cumulative number of days that the limited wet weather discharge was activated since January 1 of the current year. Reason for Discharge: Attach to the DMR a brief explanation of the factors contributing to the need to activate the limited wet weather discharge. DEP Form 62-620.910(10), Effective Nov. 29, 1994 AMENDED FACT SHEET FOR STATE OF FLORIDA DOMESTIC WASTEWATER FACILITY PERMIT PA FILE NUMBER: FL0128937-016-DW1P/RM FACILITY NAME: City of Clearwater- Northeast Water Reclamation Facility (WRF) FACILITY LOCATION: 3290 S.R. 580, Safety Harbor, FL 34695 Pinellas County NAME OF PERMITTEE: City of Clearwater PERMIT WRITER: Belinda Oliver 1. SUMMARY OF APPLICATION a. Chronology of Application Application Number: FL00129837-016-DW 1 P/RM Application Submittal Date: August 21, 2019 b. Type of Facility Domestic Wastewater Treatment Plant Ownership Type: SIC Code: c. Facility Capacity County 4952 Existing Permitted Capacity: Proposed Increase in Permitted Capacity: Proposed Total Permitted Capacity: 2. CHANGES REQUESTED BY PERMITTEE: 13.5 mgd Annual Average Daily Flow 0 mgd Annual Average Daily Flow 13.5 mgd Annual Average Daily Flow In an application for a substantial revision, received on August 21, 2019, the permittee requested the following permit revisions: • Temporarily bypassing the pumping and grit removal during construction; demolishing the existing one MGD Plant/irrigation tank; converting the four Pickett thickeners back to grit removal using stacked tray head cell technology and re -locating the grit removal unit process to its original configuration immediately following the screening process; rehabilitate two existing hydro -cyclones and one existing grit classifier; installing one new hydro -cyclone and one new grit classifier; installing four new grit pumps, and the construction and installation of a new equalization basin. This permit revision does not include an authorization to increase effluent discharges to surface waters. In addition, the applicant requested changes to the draft permit on October 8, 2019. Those changes included the following permit revisions: • Upgrades to the existing North and South sludge and blend tanks with new tank covers and mixers; installation of two new pump station and canopies (Truck Off -Loading pump station and anaerobic digester feed pump station); replacement of the dewatering feed pump station and canopies, rehabilitation of the existing truck off-loading pump stations and the replacement of the aging yard piping. 3. CHANGES FROM ISSUED PERMIT TO DRAFT PERMIT MODIFICATION: The current wastewater permit for this facility FL00128937-014-DW1P/NR and associated revisions FL00128937- 015-DW1P/MR, expire on July 1, 2022. The only item changed from the current permit was an updated wastewater treatment description to include the Second Modification changes requested by the permittee. 4. CHANGES FROM ISSUED DRAFT PERMIT MODIFICATION TO FINAL PERMIT MODIFICATION: a. Corrected a typographical error in Table B.1. in the permit by changing the units for the Parameter, Fecal Coliform from #/100 mL to percent. No change was necessary for the DMR. b. The project code was changed from DW1P/RA to DW1P/RM to more closely match the updated project type. 5. THE ADMINISTRATIVE RECORD The administrative record including application, draft permit, fact sheet, public notice (after release), comments received, and additional information is available for public inspection during normal business hours at the location specified in item 6. Copies will be provided at a minimal charge per page. 6. PROPOSED SCHEDULE FOR PERMIT ISSUANCE Draft Permit and Public Notice to Applicant and EPA September 25, 2019 Public Comment Period Beginning: October 11, 2019 Ending: November 12, 2019 Notice of Permit Issuance November 19, 2019 5. DEP CONTACT Additional information concerning the permit issuance may be obtained during normal business hours from: Belinda Oliver Engineer Southwest District Office 13051 N. Telecom Pkwy, Suite 101 Temple Terrace, FL 33637-0926 Belinda.Oliver(c�floridadep.gov Telephone No.: 813-470-5871 SWFWMD ERP Minor Modification An Equal Opportunity Employer August 09, 2019 "'§ 4 4 1 2379 Broad Street, Brooksville, Florida 34604-6899 (352) 796-7211 or 1-800-423-1476 (FL only) Water Management District g SUNCOM 628-4150 TDD only 1-800-231-6103 (FL only) On the Internet at: WaterMatters.org Bartow Service Office 170 Century Boulevard Bartow, Florida 33830-7700 (863) 534-1448 or 1-800-492-7862 (FL only) City of Clearwater Attn: David Porter 1650 N. Arcturas Avenue, Building C Clearwater, FL 33765 Sarasota Service Office 6750 Fruitville Road Sarasota, Florida 34240-9711 (941) 377-3722 or 1-800-320-3503 (FL only) Tampa Service Office 7601 Highway 301 North Tampa, Florida 33637-6759 (813) 985-7481 or 1-800-836-0797 (FL only) Subject: Notice of Intended Agency Action - Approval ERP Minor Modification Project Name: Northeast Water Reclamation Facility Grit, Salsnes & EQ Basin Modifications App ID/Permit No: 788702 / 43005372.007 County: Pinellas Letter Received: July 31, 2019 Expiration Date: August 09, 2024 Sec/Twp/Rge: S21/T28S/R16E Dear Permittee(s): The Southwest Florida Water Management District (District) has completed its review of the application for Environmental Resource Permit modification. Based upon a review of the information you have submitted, the District hereby gives notice of its intended approval of the application. The File of Record associated with this application can be viewed at http://wwwl8.swfwmd.state.fl.us/erp/erp/search/ERPSearch.aspx and is also available for inspection Monday through Friday, except for District holidays, from 8:00 a.m. through 5:00 p.m. at the District's Tampa Service Office, 7601 U.S. Highway 301 North, Tampa, Florida 33637. If you have any questions or concerns regarding the application or any other information, please contact the Environmental Resource Permit Bureau in the Tampa Service Office. Sincerely, Michelle K. Hopkins, P.E. Bureau Chief Environmental Resource Permit Bureau Regulation Division cc: Thomas Traina P.E., King Engineering Associates, Inc. An Equal Opportunity Employer August 09, 2019 OtithWe St -( . Water Management Distric Bartow Service Office 170 Century Boulevard Bartow, Florida 33830-7700 (863) 534-1448 or 1-800-492-7862 (FL only) City of Clearwater Attn: David Porter 1650 N. Arcturas Avenue, Building C Clearwater, FL 33765 2379 Broad Street, Brooksville, Florida 34604-6899 (352) 796-7211 or 1-800-423-1476 (FL only) SUNCOM 628-4150 TDD only 1-800-231-6103 (FL only) On the Internet at: WaterMatters.org Sarasota Service Office 6750 Fruitville Road Sarasota, Florida 34240-9711 (941) 377-3722 or 1-800-320-3503 (FL only) Tampa Service Office 7601 Highway 301 North Tampa, Florida 33637-6759 (813) 985-7481 or 1-800-836-0797 (FL only) Subject: Notice of Agency Action - Approval ERP Minor Modification Project Name: Northeast Water Reclamation Facility Grit, Salsnes & EQ Basin Modifications App ID/Permit No: 788702 / 43005372.007 County: Pinellas Letter Received: July 31, 2019 Expiration Date: August 09, 2024 Sec/Twp/Rge: S21/T28S/R16E Dear Permittee(s): The Southwest Florida Water Management District (District) is in receipt of your application for the Environmental Resource Permit modification. Based upon a review of the information you submitted, the application is approved. This modification to Permit No. 40005372.000 authorizes the following: 1. The removal and replacement of a wastewater treatment tank and associated infrastructure. The Engineer -of -Record has demonstrated that the proposed improvements will have no significant impact on the design rate, volume, quality, or manner of stormwater discharge from the site. No adverse off-site/on-site water quantity or quality impacts are expected. 2. All other terms and conditions of Permit No. 40005372.000, dated August 30, 1989 and entitled "NE Wastewater Treatment Facility," apply. Please refer to the attached Notice of Rights to determine any legal rights you may have concerning the District's agency action on the permit application described in this letter. If approved construction plans are part of the permit, construction must be in accordance with these plans. These drawings are available for viewing or downloading through the District's Application and Permit Search Tools located at www.WaterMatters.orq/permits. App ID/Permit No:788702 / 43005372.007 Page 2 August 09, 2019 The District's action in this matter only becomes closed to future legal challenges from members of the public if such persons have been properly notified of the District's action and no person objects to the District's action within the prescribed period of time following the notification. The District does not publish notices of agency action. If you wish to limit the time within which a person who does not receive actual written notice from the District may request an administrative hearing regarding this action, you are strongly encouraged to publish, at your own expense, a notice of agency action in the legal advertisement section of a newspaper of general circulation in the county or counties where the activity will occur. Publishing notice of agency action will close the window for filing a petition for hearing. Legal requirements and instructions for publishing notices of agency action, as well as a noticing form that can be used, are available from the District's website at www.WaterMatters.orq/permits/noticing. If you publish notice of agency action, a copy of the affidavit of publication provided by the newspaper should be sent to the District's Tampa Service Office for retention in this permit's File of Record. If you have any questions or concerns regarding your permit or any other information, please contact the Environmental Resource Permit Bureau in the Tampa Service Office. Sincerely, Michelle K. Hopkins, P.E. Bureau Chief Environmental Resource Permit Bureau Regulation Division Enclosures: Notice of Rights cc: Thomas Traina P.E., King Engineering Associates, Inc. Notice of Rights ADMINISTRATIVE HEARING 1. You or any person whose substantial interests are or may be affected by the District's intended or proposed action may request an administrative hearing on that action by filing a written petition in accordance with Sections 120.569 and 120.57, Florida Statutes (F.S.), Uniform Rules of Procedure Chapter 28-106, Florida Administrative Code (F.A.C.) and District Rule 40D-1.1010, F.A.C. Unless otherwise provided by law, a petition for administrative hearing must be filed with (received by) the District within 21 days of receipt of written notice of agency action. "Written notice" means either actual written notice, or newspaper publication of notice, that the District has taken or intends to take agency action. "Receipt of written notice" is deemed to be the fifth day after the date on which actual notice is deposited in the United States mail, if notice is mailed to you, or the date that actual notice is issued, if sent to you by electronic mail or delivered to you, or the date that notice is published in a newspaper, for those persons to whom the District does not provide actual notice. 2. Pursuant to Subsection 373.427(2)(c), F.S., for notices of intended or proposed agency action on a consolidated application for an environmental resource permit and use of state-owned submerged lands concurrently reviewed by the District, a petition for administrative hearing must be filed with (received by) the District within 14 days of receipt of written notice. 3. Pursuant to Rule 62-532.430, F.A.C., for notices of intent to deny a well construction permit, a petition for administrative hearing must be filed with (received by) the District within 30 days of receipt of written notice of intent to deny. 4. Any person who receives written notice of an agency decision and who fails to file a written request for a hearing within 21 days of receipt or other period as required by law waives the right to request a hearing on such matters. 5. Mediation pursuant to Section 120.573, F.S., to settle an administrative dispute regarding District intended or proposed action is not available prior to the filing of a petition for hearing. 6. A request or petition for administrative hearing must comply with the requirements set forth in Chapter 28-106, F.A.C. A request or petition for a hearing must: (1) explain how the substantial interests of each person requesting the hearing will be affected by the District's intended action or proposed action, (2) state all material facts disputed by the person requesting the hearing or state that there are no material facts in dispute, and (3) otherwise comply with Rules 28-106.201 and 28-106.301, F.A.C. Chapter 28-106, F.A.C. can be viewed at www.flrules.org or at the Districts website at www.WaterMatters.org/permits/rules. 7. A petition for administrative hearing is deemed filed upon receipt of the complete petition by the District Agency Clerk at the District's Tampa Service Office during normal business hours, which are 8:00 a.m. to 5:00 p.m., Monday through Friday, excluding District holidays. Filings with the District Agency Clerk may be made by mail, hand -delivery or facsimile transfer (fax). The District does not accept petitions for administrative hearing by electronic mail. Mailed filings must be addressed to, and hand -delivered filings must be delivered to, the Agency Clerk, Southwest Florida Water Management District, 7601 Highway 301 North,Tampa,FL 33637-6759. Faxed filings must be transmitted to the District Agency Clerk at (813) 367-9776. Any petition not received during normal business hours shall be filed as of 8:00 a.m. on the next business day. The District's acceptance of faxed petitions for filing is subject to certain conditions set forth in the District's Statement of Agency Organization and Operation, available for viewing at www.WaterMatters.org/about. 3 JUDICIAL REVIEW I1. Pursuant to Sections 120.60(3) and 120.68, F.S., a party who is adversely affected by District action may seek judicial review of the District's action. Judicial review shall be sought in the Fifth District Court of Appeal or in the 1 appellate district where a party resides or as otherwise provided by law. 2. All proceedings shall be instituted by filing an original notice of appeal with the District Agency Clerk within 30 I days after the rendition of the order being appealed, and a copy of the notice of appeal, accompanied by any filing fees prescribed by law, with the clerk of the court, in accordance with Rules 9. 110 and 9.190 of the Florida Rules of Appellate Procedure (Fla. R. App. P.). Pursuant to Fla. R. App. P. 9.020(h), an order is rendered when a signed written order is filed with the clerk of the lower tribunal. 4 APPENDIX — FORMS AND OTHER PROJECT DOCUMENTATION GEOTECHNICAL SOIL REPORT Driggers Engineering Services, Inc. Report of Geotechnical Investigation, dated March 23, 2017 APPENDIX 5 Updated 12/3/2020 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 REPORT OF THE GEOTECHNICAL INVESTIGATION PROPOSED EQUALIZATION TANK NORTHEAST WWTP PINELLAS COUNTY, FLORIDA Driggers Engineering Services Incorporated D R 1 G G E R S ENGI Geotechnical King Engineering Associates, Inc. 4921 Memorial Highway Suite 300 One Memorial Center Tampa FL 33634 ATTENTION: RE: Dear Tom: NEERING S E R V I CES INCORP Engineering & Construction Materials Testing Mr. Thomas A. Traina, P.E. Report of the Geotechnical Investigation Proposed Equalization Tank Northeast WWTP Pinellas County, Florida Our File DES 167824 March 23, 2017 ORAT In accordance with your authorization, DRIGGERS ENGINEERING SERVICES, INC. has completed an investigation of subsurface conditions in the area planned for the proposed equalization tank. Presented herein are the results of our geotechnical investigation, together with recommendations for subgrade preparation and foundation support. FIELD INVESTIGATION PROGRAM Plate I of the report attachments identifies the respective positioning of three (3) Standard Penetration Test (SPT) borings that were performed to investigate subsurface conditions in the area of the proposed equalization tank. The Standard Penetration Test boring logs present visual and estimated Unified soil classification corresponding to each sample interval. The test boring logs also present tabulated and graphically plotted penetration resistance values corresponding to each sample interval. Please note that the lines connecting the graphically plotted penetration resistance values are for ease of visual interpretation and do not imply a linear variation in soil properties. At each SPT boring location, the upper six (6) feet was hand augered as a double-check for utility conflicts. A hand cone penetrometer sounding was performed with penetration Sarasota Phone: 727.471.6655 Fax: 941.371.8962 saroffice@driggers-eng.com Clearwater P.O. Box 17839 • Clearwater, Florida 33762 Phone: 727.571.1313 • Fax: 727.471.6653 clwoffice @driggers-eng.com Spring Hill Phone: 727.471.6657 Fax: 727.471.6653 sphilloffice@driggers-eng.co EDI 1 1 1 1 1 1 1 1 2 resistance in tons per square foot recorded at one (1) foot intervals. Results are included in the report appendix together with a description of the Hand Cone Penetration test. The test borings were performed utilizing the Standard Penetration Test method of sampling per ASTM D-1586. Logs of the SPT borings are presented in the report attachments and illustrated in profile on Plate II of the report Appendix. A brief description of this method of testing is also appended for the interested reader. Two (2) shallow classification borings were also requested to a depth of five (5) feet at the approximate locations identified on Plate I. Logs of the classification borings are included in the report attachments reflecting visual together with estimated Unified soil classification. LABORATORY TESTING A limited laboratory testing program. was also undertaken to aid in establishing the engineering characteristics of the subsurface soils. Our laboratory tests included grainsize analyses, Atterberg Limits and natural moisture content determinations. The results of our laboratory tests are included in the report attachments. GENERALIZED SUBSURFACE CONDITIONS The program of test borings identified a somewhat variable near -surface soil profile. Based upon our historic experience conducting geotechnical investigations at this plant site, test boring SB -2 is generally reflective of topical subsurface conditions. SB -2 reflected the presence of predominately fine sands with trace amounts of organic fines extending to a depth of about eight (8) feet, underlain by silty to slightly clayey sands to some 14 feet below existing grade. The intermediate silty to slightly clayey sands belowl 0 feet exhibited relatively low penetration resistance values, suggesting loose to very loose conditions. Penetration resistance values increased below 14 feet as medium dense silty to clayey sands overlay hard and variable cemented clays that extended from a depth of about 23 feet to the surface of the underlying limestone formation encountered at a depth of about 50 feet. The limestone formation continued to the termination depth of about 60 feet, and included interbedded seams of variably cemented clays. Test boring SB -3 encountered similar conditions to SB -2, with the exception of the presence of a very soft clay seam in the depth range of about eight (8) to 10 feet. Driggers Engineering Services Incorporated 3 SB -1 was performed very close to the perimeter of the existing effluent irrigation storage tank. This test boring suggested the possible presence of sandy fill soils with pockets of clayey sand within the upper 8 to 10 feet. Below 10 feet, penetration resistance values increased as medium dense slightly silty fine sands continued belowl0 feet, terminating above medium dense clayey sands with variable cementation below 13 to 14 feet. It should be noted that the base slab for the existing irrigation storage tank is anticipated at approximate El. +47.5 ft. or about 11 feet below the ground surface at test boring SB -1. Considering the added thickness of the existing tank slab and proximity of this test boring to the existing tank, it is likely that the area at SB -1 had been previously over -excavated to at least 12 feet to construct the tank and then subsequently backfilled to existing grade. Notwithstanding, deeper subsurface conditions, typically below 12 to 14 feet, are very similar to conditions encountered at the neighboring borings SB -2 and SB -3 as well as many other borings that have been performed at this site by our ficin over the years. Classification boring HA -1 appeared to encounter upper zones of sands and sandy clays extending to about 3.4 feet below existing grade. Fine sands occurred below that depth to the termination of the classification boring. These upper sands with pockets or seams of sandy clays also probably represent historicaIIy placed fill or backfill materials. Classification boring HA -2 reflected a more typical near -surface soil profile consisting of predominately fine sands throughout the depth of the classification boring with the exception of a surficial seam of sands with Iimerock gravel. Groundwater was encountered in the depth range of about 4.0 feet to 7.4 feet, representing the elevation range of El. +51.2 ft. to El. +51.9 ft., with an average of about El. +51.5 ft. It should be noted that these test borings were performed in late February, during a period of minimal rainfall. One should certainly anticipate a nominal one (1) to two (2) foot rise in groundwater levels during the normal wet season. However, it is recognized that well- developed surface drainage, as is commonly established within a treatment plant site, can tend to diminish seasonal fluctuations in groundwater levels. If critical to design or construction, it would be advisable to install some shallow piezometers and maintain observations of groundwater levels during the upcoming wet season. Driggers Engineering Services Incorporated 4 GEOTECHNICAL EVALUATION AND RECOMMENDATIONS PROPOSED EQUALIZATION TANK — The proposed equalization tank will overlap the majority of the footprint of the existing effluent irrigation storage tank. Of significance is the fact that the existing tank is supported on a mat foundation which probably occurs at approximate El. +46.5 ft. or some 13 feet below the grade at the perimeter of the existing tank. The base slab for the proposed equalization tank will generally slope from a high of near El. +60.0 ft. down to a low of about El. + 57.0 ft at the interior perimeter sump location. Considering that the top of the tank wall for the proposed equalization tank will occur at approximate El. +82.8 ft., the proposed construction will result in a superimposed dead and live load of about 1.6 ksf. The proposed construction calls for the complete removal of the existing effluent irrigation tank which would then necessitate appropriate backfilling and compaction of subgrade soils to re-establish the proposed new tank finished grade. FOUNDATION CONDITIONS — Under normal circumstances the construction of the proposed equalization tank would require no inordinate subgrade preparation nor would total and differential settlements be expected to exceed tolerable levels. However, the removal and backfilling of the existing tank under only a portion of the proposed equalization tank would result in a relatively sharp discontinuity in subgrade support conditions and create the potential for undesirable differential settlement over relatively short lateral distance. Accordingly, it is our recommendation that the entire limits of the equalization tank extending beyond the periphery of the existing irrigation tank also be over -excavated to the same depth as the previous elevation for the existing irrigation tank so that all backfill materials can be uniformly placed and compacted so as to minimize the potential for any excessive differential settlement. The over -excavation should extend throughout the extended limits of the proposed equalization tank plus a margin of not less than ten (10) feet measured at the excavation bottom. The over -excavation and replacement should also encompass any appurtenant critical connecting structures. Backfill materials should consist of clean cohesionless fills soils generally comprising the SP to SP -SM Unified soil classification or as approved by the project geotechnical engineer. Suitable soils excavated can be reused as backfill. The backfill soils should be densified to not less than 95% of the Modified Proctor maximum dry density per ASTM D-1557. Backfill materials should be placed in lift thicknesses not exceeding 12 inches with each lift uniformly compacted to the aforementioned density requirement which must be confirmed by compaction testing during the backfilling operations. Driggers Engineering Services Incorporated 5 With appropriate subgrade preparation, we would anticipate that maximum total settlements of the tank interior would be in the range of 1.5 to 2.0 inches with the majority of the settlement occurring rapidly upon first filling. Differential settlements from edge to center would be expected to be on the order of an inch or less. When considering the type of construction, we would anticipate that these magnitudes of expected total and differential movement would be considered tolerable although this should be confirmed by the tank manufacturer. The perimeter ring wall foundations may be designed based upon an allowable soil bearing pressure of up to 2,500 pounds per square foot (psf). SETTLEMENT OBSERVATIONS — We recommend monitoring elevations around the tank perimeter and perhaps tank interior, where accessible, during initial tank filling. Observations should be maintained on a daily basis during filling and at least twice weekly following filling until the time -rate of settlement diminishes to acceptable levels, which we would expect to occur within two (2) to three (3) weeks. Elevations should be obtained by a qualified surveyor utilizing precise instruments so as to obtain accurate and reproducible elevations to the nearest 0.002 ± feet. The settlement observations are warranted to check predicted versus actual settlements and allow detection of any localized areas that may be experiencing settlements or differential movements that may exceed desired levels and warrant some remediation. Although we are not familiar with the details of proposed piping connections, there would certainly be merit in allowing for some rotational flexibility in connections until it can be confirmed that tank settlements have diminished to acceptable levels. CONTROL AND MANAGEMENT OF GROUNDWATER — During the over -excavation and re -compaction operations, it will be necessary to effect proper control and management of groundwater. Groundwater should be maintained at least one (1) foot below the excavation bottom. We would anticipate that this can effectively be accomplished by a combination of perimeter well -points perhaps in combination with an interior gravel drainage blanket and interior sumps. We would strongly recommend that the prospective contractor enlist the services of a qualified de -watering consultant in order to appropriately design the drainage system to effect needed groundwater lowering and avoid any pumping of soil fines. Where a gravel drainage blanket may be utilized, we would recommend that the drainage blanket be placed above an appropriate geotextile fabric in order to prevent any migration of soil fines into the drainage blanket from below due to the upward hydraulic gradient produced by de- watering operations. The drainage blanket may consist of gravel corresponding to an FDOT No. Driggers Engineering Services Incorporated 6 57 grading or finer compacted to produce a firm and unyielding condition. Furthermore, the gravel drainage blanket should be covered on the top and sides with an appropriate filter fabric in order to prevent any future downward migration of soil fines from the backfilling operations needed to re-establish existing grades. A geotextile fabric such as a Mirafie 140N or equivalent would be considered suitable. SPECIAL CONSIDERATIONS — Although details, to my knowledge, are currently unavailable, the possibility exists that a gravel drainage blanket may have been placed below the existing effluent irrigation tank to facilitate de -watering during construction activities. If present, the gravel blanket may warrant removal and replacement to insure that an appropriate geotextile fabric encapsulates the gravel drainage blanket as discussed above for the ultimate construction of the proposed equalization tank. LIGHTLY LOADED GROUND SUPPORTED STRUCTURES — It is our understanding that there may also be some relatively lightly loaded filters and electrical buildings that we would anticipate would be supported close to existing grade and potentially on shallow mat foundations. We would anticipate that these can be supported with routine subgrade preparation. However, it would certainly be prudent to hand probe these structure areas to check for any historic fill materials that may not be suitable for foundation support and would otherwise warrant removal and replacement with competent structural quality backfill. As details become available with respect to specific structural loading conditions and design grades, we would welcome the opportunity to review this information and offer any additional, more specific recommendations relative to subgrade preparation. DRIGGERS ENGINEERING SERVICES appreciates this opportunity to serve you, and we trust that if you have any questions concerning our report or findings, you will not hesitate to contact the undersigned at your convenience. FJD/ff FJD-REP\2016\167824 Copies: Email: (1) Respectfully submitted, DRIGGER NGINEERING SERVIC kIINC. ='0DRG1104\*o .........0,......./... Wear ' e ►t'gers, P.E.It No. 16989 is ?• g • • • • .0 't• -a'. STA E= OF ••w� r 4 • • 40 r • :IP S_ ' 14 1 KAON AL - ".. Presi. e r. t FL Registration.No. 16989 Driggers Engineering Services Incorporated APPENDIX PLATE I - BORING LOCATION PLAN PLATE II - STANDARD PENETRATION TEST BORING PROFILE STANDARD PENETRATION TEST BORING LOGS HAND AUGER AND HAND CONE BORING LOGS SUMMARY OF LABORATORY TESTING GRAINSIZE ANALYSES METHOD OF TESTING Driggers Engineering Services Incorporated PLATE I - BORING LOCATION PLAN Driggers Engineering Services Incorporated ---- 0 ts T u) = >-1 > z> z 0 0Z 0 0> D. 0 X c z 0 0 mri -0 Fr; M Z 0 It x CO M 0Z w �P1 0 ZHO , 0 0 0 > 0 7_,1 0 Z Z 0CI3 x 2 o co 1 -I M -0 >--o N(I) > m 0 z > Z EN O. POT _..'--- ,,,.11 Illlill ll-lll'-l'l, calci'Ill NN WWI „ 1171111 \ U -7,14-44- 14.14 I- ___I III , 11111 \ E PI 1 d I,;11:F T: db \ a 1 1 —on EAAA,Tit .- t 1 I — n CD -.a- al 1 c.,., 1 11111 11111 .. , t I At e Hill um / I t '---, I 1 I I I t c., 1 m I u., 0 › M M M -I 1: At i— t t s t 1 1 Al LA) m tI 0 ;11 X „ ATI -4 1 z _ I i x 0 • n 1 -, N 0 , I Z I , 0 II , X I I , , I C1 . r? - L. 1 e , m w Z PROJECT NUMBER: 167824 DATE: V1/17 CAD / ENGINEER SHEET TITLE PROJECT NO. R.D.B. / F.J.D. BORING LOCATION PLAN DES 167824 PRIEPAERNEGDINBEYERING PROJECT NAME SHEET NO. . . 1 , lin PROPOSED EQUAUZA11ON TANK NORTHEAST WWTP PINELLAS COUNTY, FLORIDA PLATE I DRIGGERS SERVICES, INCORPORATED 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 PLATE II - STANDARD PENETRATION TEST BORING PROFILE Driggers Engineering Services Incorporated NM 1E11 11111I INN 11E1 MN NMI MEI RN MN 111111 MIN 111111 SOIL BORING PROFILE Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida SB 1 60 60 ELEVATION IN FEET 64 0 0 (Ti I I I I 1 SB -2 SB -3 .•;.;:•: • i•_- :4,-....,. ELEVATION IN FEET Lo 0 .4. 00 10 0 I 1 I i I I I I I I 1 I : ..... •• •• • • ____ ...• • • _____:•__TZ., 6 _ . .. .. _ • .. . . 2/25/17 8 2/21/17 o• 2/21/17 • • • • • • • -..1:f;•rti 18 . . 12 2 ' • • • • •I •I•j• i C . . 16 : g . r : : 22 P" • 16 0 0 25 :•: ' 100 . ..1‘. •ti .., . '•:)11. ... 11 22 34 17 • • • • 100 100 • • • jfr 100 100 • • • • 100 100 38 26 i a 24 100 73 • • •4 41 100 • 43 4 JI/ 100 6 inn 100% 98 _LTL 50% 11 100 , 100 100 — -15 - LEGEND: -15 — lo, Denotes Percent Loss of Circulation _ . -30 strata symbols 1111 Fine SAND with organics 40140 Silty, clayey Fine SAND :Witt LIMESTONE -30 71174: .•,,, : -, : 4: 7:77T .L1A-L1 Fine SAND with roots Fine SAND '!'"1 _1! Silty, slightly clayey Fine SAND Silty, slightly clayey Fine SAND withFrA, cemented fragments DRIGGERS ENGINEERING w r0,4: PWA rj,,,/ t Sandy CLAY Cemented CLAY SERVICES, INC. raw. r/A. WI CLAY Clayey Fine SAND PLATE II NM 1E11 11111I INN 11E1 MN NMI MEI RN MN 111111 MIN 111111 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 STANDARD PENETRATION TEST BORING LOGS Driggers Engineering Services Incorporated DRIGGERS ENGINEERING SERVICES INCORPORATED Project No. DES 167824 BORING NO. SB -1 Project Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida Location See Plate 1 Foreman Completion Depth 61.0' Date 2/21/17 Water 7.4' Time Depth To J.R. Date 2/21/17 x a. W 0 0 J 0 >- w a - Q SOIL DESCRIPTION SURF. EL: +58.6+/-' Grayish -brown Fine SAND with grass and roots (SP) Dark brown Fine SAND (SP) Loose brown Fine SAND with pockets of brown clayey Fine SAND (SP/SC) - 10 Very loose to medium dense ":'': brown slightly silty Fine SAND (SP -SM) eaa:r— i;•t rci i. r. - 25 °Z; .71 r:// - 30 Medium dense gray clayey Fine SAND (SC) Medium dense grayish -green variably cemented, silty Fine SAND (SM) Hard green cemented, sandy CLAY (CL) Hard green CLAY with trace of cemented clay fragments (CL) Hard green cemented CLAY (CL) Ce (22 paw W 0 IL m0 < Q 3/3/3 1/1/2 3/7/11 1/2/14 7/10/12 21/50* 12/16/18 49/50* STANDARD PENETRATION TEST BLOWS/FT. ON 2" O.D. SAMPLER -140 LB. HAMMER, 30" DROP (AUTOMATIC HAMMER) 10 20 40 60 80 * 0.5' P enetration l -* 0.1' Penetration ti Remarks Borehole Grouted Casing Length 20.0' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 iiiJI!!i DRIGGERS ENGINEERING SERVICES INCORPORATED Project No. DES 167824 BORING NO. SB -1 Project Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida Location See Plate I Foreman J.R. Completion Depth To Depth 61.0' Date 2/21/17 Water 7.4' Time Date 2/21/17 cWri DEPTH, FT SYMBOL u) in a. Q < SOIL DESCRIPTION SURF. EL: +58.6+/-' BLOWS ON SAMPLER PER 6" OR PEN. STR. STANDARD PENETRATION TEST BLOWS/FT. ON 2" O.D. SAMPLER -140 LB. HAMMER, 30" DROP (AUTOMATIC HAMMER) 10 20 40 60 80 • _ Hard green cemented CLAY (CL) * 0000 50* 0.2' Penetrat on ■.,1111 01 ��•uiiun 1/11 40 I __Ell 01111 1111 _4_ 7/20/18 ��•//.11111 er Very stiff dark green CLAY (CH) 11111 45 I / ��.�,1111 5/10/14 IM 1111 -r 50 • Hard dark green CLAY with limestone fragments (CL) ��.I1.u1111 __.��,1111 11111111 , • 15/21 /20 « ��..►11111 rilA colored clayey LIMESTONE ■�„ 11111 55 �,_. / with seams of green CLAY ��...�1111 10/50* * 0.3' Penetration ■., 111, C__•u.,111 60 �II AEA - 100% loss ofcirculation at depth 58.0' ��....111l 13/50* *0.5' Penetration ... ...U1111 1111 1111 11111111 ■.�On 65 C1111 ==:uiniiI ��..■1111 Remarks Borehole Grouted Casing Length 20.0' dLS DRIGGERS ENGINEERING SERVICES INCORPORATED Project No. DES 167824 BORING NO. SB -2 Project Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida Location See Plate I Completion Depth 60.4' Date 2/20/17 Water 4.3' Time Depth To Foreman J.R. Date 2/20/17 J O m >- 0 st_ J a 15 20 25 30 of,A 00, SOIL DESCRIPTION SURF. EL: +55.5+/-' Brownish -gray Fine SAND with roots (SP) Grayish -brown Fine SAND (SP) Very dark brown Fine SAND with finely divided organic material (SP) Brown Fine SAND (SP) Loose light brown Fine SAND (SP) Medium dense grayish -brown silty, slightly clayey Fine SAND (SM) Very loose to loose gray silty, slightly clayey Fine SAND with cemented fragments (SM) Medium dense green silty, clayey Fine SAND (SM -SC) Hard green cemented CLAY (CL) Z W Oaf J W 0 CL CO 2/3/5 4/7/5 WH/1/1 WH/1/8 5/7/9 4/4/7 8/33/50* 50* STANDARD PENETRATION TEST BLOWS/FT. ON 2" O.D. SAMPLER -140 LB. HAMMER, 30" DROP (AUTOMATIC HAMMER) 10 20 40 60 80 11111111111 11111111111 1 1111111 11111111111111 1111 � 111 111111111 11111111111111111 11/111111111111 L �II Mbl 11111111111111111111 11111111 1111111 1111111 11111111111 1111111111 NM 111 1 * 0.2' Penetration * 0.5' Penetration Remarks Borehole Grouted WH = Weight of Hammer Casing Length - 20.0' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 DRIGGERS ENGINEERING SERVICES INCORPORATED Project No. DES 167824 BORING NO. SB -2 Project Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida Location See Plate I Foreman Completion Depth 60.4' Date 2/20/17 Water Depth To 4.3' Time J.R. Date 2/20/17 H LL a w 0 J 0 m w J o_ SOIL DESCRIPTION SURF. EL: +55.5+1-' Z }- 0 O a- CD Z J a O l..� m<O STANDARD PENETRATION TEST BLOWS/FT. ON 2" O.D. SAMPLER -140 LB. HAMMER, 30" DROP (AUTOMATIC HAMMER) 351. Hard green cemented CLAY (CL) V �V T V vv vv 25/50* *0.3' Penetration ..,"' • 1111111 40ru,111 - very stiff seam at depth 40.0'15/15/11 __..,111 ��•M. Ile 111 III - 1111 .! 45•_ ■•,11� 50* * 0.4' Penetration 111111 .' 111 III 1111 f4 50500.2 111111 ii' Cream colored LIMESTONE * Penetration ..,111 t c ` II% .iev Hard green cemented CLAY with seams of cream colored LIMESTONE (CL) 15/27/21 _-■■.N11' --���1111 111111 ill 1111 55 -• x, e V •, 60 ' '', ti Cream colored clayey LIMESTONE 1111111 with seams of green CLAY 50* * 0.4' Penetration ■.,1111 1111 ��R1111111 1111 IIM 65 1111 111111 Remarks Borehole Grouted WH = Weight of Hammer Casing Length 20.0' DRIGGERS ENGINEERING SERVICES INCORPORATED Nroject No. DES 167824 BORING NO. SB -3 Project Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida Location See Plate I Foreman J.R. Completion Depth To Depth 60.2' Date 2/21/17 Water 4.1' Time Date 2/21/17 LL = w p J p m >- Q �, w a.:11 0-J SOIL DESCRIPTION SURF. EL: +56.0+/-' Z w 0 0- o f.6z a * m < 0 C° STANDARD PENETRATION TEST BLOWS/FT. ON 2" O.D. SAMPLER -140 LB. HAMMER, 30" DROP (AUTOMATIC HAMMER) 10 20 40 60 80 0 -Dark Fine grayish -brown SAND with grass • ,and roots (SP) Light brown Fine SAND (SP) -_.■uiuin Dark brown Fine SAND (SP) t;:: Brown and dark brown 11 5 - :i*1 Fine SAND with trace of finely divided organic material (SP) 11" -- -; Loose green clayey Fine SAND (SC) 2/2/3 I 111 Very soft green sandy CLAY (CH) 1/1/1 10 • IL 1111 Loose grayish green silty, 1111 slightly clayey Fine SAND (SM) 4/4/1 11111 11 11111 4/4/2 IBM. 15 1f1f( ! f iR1�� d 1,,�1,. 11/1111 d , Medium dense green silty, clayey Fine SAND SM SC ( ) 9/13/12 __�11I11�� �� El 118f min too Medium dense green clayey Fine SAND (SC) ■.111111111 20 111111 1111 111 13/13/9 1111 � Very stiff grayish -green CLAY(CH ) 11111111 111 25 111r1 nil 10/7/10 1�11,1111 �• •• Hard green cemented CLAY (CL) 1111111 30 * 11/32/50* 0.4' Penetration OR •__.1111111 • 1111111 Remarks Borehole Grouted Casing Length 20.0' 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 DRIGGERS ENGINEERING SERVICES INCORPORATED Project No. DES 167824 BORING NO. SB -3 Project Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida Location See Plate I Foreman Completion Depth 60.2' Date 2/21/17 Water 4.1' Time Depth To J.R. Date 2/21/17 u O w I m ii w ' < p U) 35 ✓. 40 SOIL DESCRIPTION SURF. EL: +56.0+/-' 50 Hard green cemented CLAY (CL) Very stiff dark green CLAY (CH) Cream colored clayey LIMESTONE with seams of green CLAY Hard green cemented CLAY (CL) 55 - 60 Cream colored LIMESTONE 50% loss of circulation at depth 58.0' 65 - 39/46/50* 11/9/10 41/39/34 15/19/24 50* 50* Remarks Borehole Grouted STANDARD PENETRATION TEST BLOWS/FT. ON 2" O.D. SAMPLER -140 LB. HAMMER, 30" DROP (AUTOMATIC HAMMER) 10 20 40 60 80 *0.2' Penetration 111111111 11111111 11111111111 1111111111111 111111111111 111111111 111111111/1111 111111111111111111111111 11111111 111111111111 MINIM 11111111111111 111111111111111 1111111111111 * 0.1' Penetration * 0.2' Penetration Casing Length 20.0' HAND AUGER AND HAND CONE BORING LOGS Driggers Engineering Services Incorporated 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 DRIGGERS ENGINEERING SERVICES INCORPORATED HAND AUGER BORING/HAND CONE SOUNDING LOG PROJECT: Proposed Equalization Tank Northeast WWTP Pinellas County, Florida Project No.: DES 167824 CLIENT: King Engineering Associates Inc. WATER TABLE: See "Note" DATE: 2/21/17 TECHNICIAN: J.R./B.D. DATE: 2/21/17 COMPLETION DEPTH: 6.0' LOCATION: See Plate I TEST NUMBER: SB -1 ELEV. (FT) DESCRIPTION DEPTH (FT) -J m u HAND CONE TIP RESISTANCE (TSF) 0 10 20 30 40 50 60 70 58 Grayish -brown Fine SAND with grass and roots (SP) 0 -, v'Y' �f y.� 41 • : 2 .'-..;,• Y4.... -;.' - 56 yl =1 V. ::�t'< :i::1, 4 Dark brown Fine SAND (SP) • - 54 - 52 Surface Elevation: +58.6+/-' Note: Water Table not encountered within depth of 6.0'. .a 50 - 10 - 48 - 12 - 46 LEGEND: a + Denotes Penetration Resistance in excess of 50 TSF 14 - DRIGGERS ENGINEERING SERVICES INCORPORATED1' HAND AUGER BORING/HAND CONE SOUNDING LOG PROJECT: Proposed Equalization Tank Northeast WWTP Pinellas County, Florida Project No.: DES 167824 CLIENT: King Engineering Associates Inc. WATER TABLE: 4.3' DATE: 2/20/17 TECHNICIAN: J.R./B.D. DATE: 2/20/17 COMPLETION DEPTH: 6.0' LOCATION: See Plate I TEST NUMBER: SB -2 ELEV. (FT) DESCRIPTION DEPTH (FT) _J m HAND CONE TIP RESISTANCE (TSF) 0 10 20 30 40 50 60 70 Brownish -gray Fine SAND 0 !•,--1: =i` • ;4: • • : \------>) with grass and roots (SP) 54 Grayish brown Fine SAND (SP) Very dark brown Fine SAND - 2 = ` �'� M.- with finely divided organic material (SP) 7.---- 52 Brown Fine SAND (SP) -,I I.' - 4 .. • . . - 50 - '-6 Surface Elevation: +55.5+/-' 48 - - g - 46 - 10 - - 44 - 12 - LEGEND: - 42 - • + Denotes Penetration Resistance in excess of 50 TSF - 14 - 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 DRIGGERS ENGINEERING SERVICES INCORPORATED HAND AUGER BORING/HAND CONE SOUNDING LOG PROJECT: Proposed Equalization Tank Northeast WWTP Pinellas County, Florida Project No.: DES 167824 CLIENT: King Engineering Associates Inc. WATER TABLE: 4.1' DATE: 2/21/17 TECHNICIAN: J.R./B_D. DATE: 2/21/17 COMPLETION DEPTH: 6.0' LOCATION: See Plate I TEST NUMBER: SB -3 ELEV. (FT) DESCRIPTION DEPTH (FT) SYMBOL HAND CONE TIP RESISTANCE (TSF) 0 10 20 30 40 50 60 70 56 Dark grayish -brown Fine SAND with grass and roots (SP) 0 • : •� 16 - Light brown Fine SAND (SP) • 54 2 Al Dark brown Fine SAND (SP) f. 52 4 Brown and dark brown Fine SAND with trace of finely divided organic material (SP)•• f�" ;; • : 50 Surface Elevation: +56.0+/-' 6 I 48 8 46 10 44 12 42 14 DRIGGERS ENGINEERING SERVICES INCORPORATED HAND AUGER BORING LOG PROJECT: Proposed Equalization Tank Northeast WWTP CLIENT: King Engineering Associates, Inc. Pinellas County, Florida Project No.: DES 167824 WATER TABLE: 4.0' DATE: 2/20/17 TECHNICIAN: J.R./C.D_/B.D. DATE: 2/20/17 COMPLETION DEPTH: 5.3' LOCATION: See Plate I TEST NUMBER: HA_1 (FT) DESCRIPTION DE (FT) SYMBOL REMARKS 55 Grayish -brown Fine SAND with roots 0 :; :: y.; ,:'• : � Surface Elevation: +55.8+/--' :,;:. fri.�z ..✓w • •:.nt -':.,. 54 1;- Brown Fine SAND with pockets. of green sandy CLAY (SP/CH) .: ••• :, y 53 - - 2 - 52 - Green sandy CLAY (CH) - 3 K:. Brown Fine SAND (SP) : 51 4 Gray and dark gray Fine SAND (SP). .::.• . - 50 - 5 ,:.• - 49 - _ 6 - - 48 - 7 - DRIGGERS ENGINEERING SERVICES INCORPORATED HAND AUGER BORING LOG PROJECT: Proposed Equalization Tank Northeast WWTP Pinellas County, Florida Project No.: DES 167824 CLIENT: King Engineering Associates, Inc. WATER TABLE: 3.8' DATE: 2/20/17 TECHNICIAN: J.R./C.D./B.D. DATE: 2/20/17 COMPLETION DEPTH: 5.2' LOCATION: See Plate I TEST NUMBER: HA -2 ELEV (FT) DESCRIPTION DE T}H SYMBOL REMARKS Brown Fine SAND with Limerock Gravel and roots (SP)p.. 0 ' i Surface Elevation: +55.3+/-' 55 - • Brown Fine SAND with trace of roots (SP) :: •� : • 1 -:� - 54 Grayish -brown to dark brown Fine SAND (SP) . •• •• L. :. . Brown Fine SAND (SP) 2 -r•':'• 53 _ Light brown Fine SAND with trace of roots (SP) ..a 52 - 4 51 Brown Fine SAND (SP) • • . 5 - 50 - 6 - 49 - 7 _ 1 SUMMARY OF LABORATORY TESTS Driggers Engineering Services Incorporated r-- N 1 N- -- N- NM N RR M NM M N M SUMMARY OF LABORATORY TEST RESULTS BORING NO. DEPTH (ft) DESCRIPTION W % Y d (pcf) G 5 ATTERBERG LIMITS P.P. (tsf) U.C. CON. G.S. ORG. ('11) pH Cl. (ppm) SO 4 (ppm) RES. (ohm -cm) LL PL PI SB -1 8.0-9.5 Brown slightly silty Fine SAND SB -2 8.0-9.5 Grayish -brown silty, slightly clayey Fine SAND 17.5 NP NP .4 15.7 SB -2 10,0-11.5with Grayish -brown silty, slightly clayey Fine SAND cemented fragments 29.5 NP NP •. 22.8 SB -2 15.0-16.5 Green silty, clayey Fine SAND 35.0 64 36 28 .. 31.8 SB -2 20.0-21.5 Green clayey Fine SAND 29 0 63 35 28 0.75 SB -3 12.0-13.5 Grayish -green silty, slightly clayey Fine SAND 30.8 35 19 16 .. 21.6 W % = Water Content Y d (pcf) = Dry Density Gs = Specific Gravity LL = Liquid Limit PL = Plastic Limit PI = Plasticity Index P.P. (tsf) = Pocket Penetrometer U.C. = Unconfined Compression Con. G.S. (+1) ORG. (%) Cl. (ppm) SO4 (ppm) RES. (ohm -cm) ** • Consolidation Tes • Grainsize Analysis (Hydrometer) • Organic Content ▪ Total Chloride = Total Sulfate • Lab Resistivity • See Test Curves • Percent Passing No. 200 Sieve CLIENT: PROJECT: FILE: King Engineering Associates, Inc. Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida DES 167824 GRAINSIZE ANALYSES Driggers Engineering Services Incorporated 11111 11111 s--- - --- -- MN MN EN E I 1 EN 1 DRIGGERS ENGINEERING SERVICES, INC I _-- U. S Standard 3 2 Siwe Openings in } 1 Inches U. S Stands d Sieve Numbers Hydrometra j 3 4 10 t1 1¢ 20 30 410 `5,0 70 100 110 2po Percent Finer by Weight s 0 0 0 o L 0 S r F 1 _ 1 t l 1 t '---F--1-----.1 ....r 1 1 t r I 11(1:0 t I T 8 g o 25 0 0 0 0 Percent Coarser by Weight 1111111111 • 100 50 10 5 0 5 0 1 0.05 0.01 0.005 0.001 Grain Size in Millimeters GRAVEL SAND SILT CLAY Coarse 1 Medium I Fine or Number Depth Natural Moisture L L. P. L P. I. Classification CLIENT: King Engineering Associates, Inc. PROJECT: Proposed Equalization Tank, Northeast WWTP, Pinellas County, Florida FILE: DES 167824 SB -1 8.0' -9.5' Brown slightly silty Fine SAND METHOD OF TESTING Driggers Engineering Services Incorporated . . STANDARD PENETRATION TEST WITH AUTOMATIC HAMMER AND SOIL CLASSIFICATION STANDARD PENETRATION TEST (ASTM D-1586) In the Standard Penetration Test borings, a rotary drilling rig is used to advance the borehole to the desired test depth. A viscous drilling fluid is circulated through the drill rods and bit to stabilize the borehole and to assist in removal of soil and rock cuttings up and out of the borehole. Upon reaching the desired test depth, the 2 inch O.D. split -barrel sampler or "split -spoon", as it is sometimes called, is attached to an N -size drill rod and lowered to the bottom of the borehole. A 140 pound automatic hammer, attached to the drill string at the ground surface, is then used to drive the sampler into the formation. The hammer is successively raised and dropped for a distance of 30 inches using an automated lifting mechanism. The number of blows is recorded for each 6 inch interval of penetration or until virtual refusal is achieved. In the above manner, the samples are ideally advanced a total of 18 inches. The sum of the blows required to effect the final 12 inches of penetration is called the blowcount, penetration resistance or "N" value of the particular material at the sample depth. After penetration, the rods and sampler are retracted to the ground surface where the core sample is removed, sealed in a glass jar and transported to the laboratory for verification of field classification and storage. SOIL SYMBOLS AND CLASSIFICATION Soil and rock samples secured in the field sampling operation were visually classified as to texture, color and consistency. The Unified Soil Classification was assigned to each soil stratum per ASTM D-2487. Soil classifications are presented descriptively and symbolically for ease of interpretation. The stratum identification lines represent the approximate boundary between soil types. In many cases, this transition may be gradual. Consistency of the soil as to relative density or undrained shear strength, unless otherwise noted, is based upon Standard Penetration resistance values of "N" values and industry -accepted standards. "N" values, or blowcounts, are presented in both tabular and graphical form on each respective boring log at each sample interval. The graphical plot of blowcount versus depth is for illustration purposes only and does not warrant continuity in soil consistency or linear variation between sample intervals. The borings represent subsurface conditions at respective boring locations and sample intervals only. Variations in subsurface conditions may occur between boring locations. Groundwater depths shown represent water depths at the dates and time shown only. The absence of water table information does not necessarily imply that groundwater was not encountered. Rev. 9/2011 BAND CONE PENETRATION TEST The cone penetration test was perfolrned using a DGSI Model 5-215 double rod Static Cone Penetrometer. Dual rods enable the cone stress to be measured directly. Soil friction on the outer rod does not influence the reading. Depending upon the application, either the maximum bearing for an increment of push or the least bearing for an increment can be reported. If you were investigating for soft spots, you would take the least reading. In typical use, you would force the cone into the soil 6 inches, retract the cone slightly until the gauge reads zero, then advance an additional 6 inch increment. If you meet with refusal, the cone can be removed and the hole opened with a hand auger to permit a continuation of measurements against depth. The tool has been designed to allow a -maximum force of250 lbfto be applied, somewhat more than the average weight of an operator. The unit can be operated in a vertical or horizontal position. The cone tip has an included angle of 60°. The cone has a section area of 1.5 err?. The maximum total bearing (Q) is 70 kg/cm2. The reading (Q) is in kg/cm2 which is essentially equal to ton/ft?. The cone index (Q) is read directly. The correlation between the cone index and soil. constants -is not absolute. Generally, the following results have been determined through extensive. field use of the rmit. Further verification of correlation in your local soil types is essential. Standard Penetration Test "N" Value Q = 4 "N" Q Strength and Cohesion Q„ - Unconfined compression (kg/cm2) c - Cohesion (kg/cm2) Uniform clay and silty clays: Clayey Silts: Q.=5Q„ Q, = 10 c Q� = (10 to 20) Q„ Q, = (20to40)c I I I I I I I I I I 1 I 1 1 I I I APPENDIX— FORMS AND OTHER PROJECT DOCUMENTATION ASBESTOS REPORT Terracon, Pre -Demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Report, dated January 19, 2017 APPENDIX 6 Updated 12/3/2020 Pre -Demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Report Northeast Wastewater Treatment Facility — Designated Structures S.R. 580 + McMullen Booth Road Clearwater, Pinellas County, Florida January 19, 2017 Terracon Project No. H4167137 Prepared for: King Engineering & Associates, Inc. Tampa, Florida Prepared by: Terracon Consultants, Inc. Tampa, Florida Offices Nationwide Established in 1965 lierracon� Employee -Owned terracon.com Geotechnical r Environmental Construction Materials • Facilities 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 lrerracon January 19, 2017 King Engineering & Associates, Inc. 4921 Memorial Highway One Memorial Center, Suite 300 Tampa, FL 33634 Attn: Mr. Thomas Traina, P.E. Senior Project Manager P: 813-880-8881 E: ttrainakinqenqineerinq.com Re: Pre -Demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Report Northeast Wastewater Treatment Facility — Designated Structures State Road 580 and McMullen Booth Road Clearwater, Pinellas County, Florida 33761 Terracon Project No. H4167137 Dear Mr. Traina: The purpose of this report is to present the results of the pre -demolition NESHAP asbestos survey, lead-based paint and hazardous materials survey report, performed on January 05, 2017 at the above referenced facility in Clearwater, Florida. This survey was conducted in general accordance with our revised proposal dated December 06, 2016. We understand that this survey was requested to identify and locate asbestos -containing materials (ACMs), lead-based paint (LBP) and potentially hazardous materials prior to future demolition & renovation activities. Asbestos was identified in samples of non -friable materials collected at the subject site. Please refer to the attached report for details. Lead was detected in painted coatings at the project site. Please refer to the attached report for details. Potentially Hazardous Materials were identified at the project site. Please refer to the attached report for details. Terracon Consultants, Inc. 5463 W. Waters Avenue, Suite 830 Tampa, FL 33634 P 813-221-0050 F 813-221-0051 terracon.com Geotechnical • Environmental • Construction Materials • Facilities lFerracon Terracon appreciates the opportunity to provide this service to King Engineering Associated, Inc. If you have any questions regarding this pre -demolition NESHAP asbestos survey, lead-based paint and hazardous materials survey, please contact the undersigned at (813) 221-0500. Sincerely, lierracon Florida Asbestos Business License Number ZA-337 Prepared by: Reviewed by: Peter MacKay, CIEC Staff Industrial Hygienist Russell E. Stauffer, P.E. Florida Licensed Asbestos Consultant EA -16 Authorized Project Reviewer Terracon Consultants, Inc. 5463 W. Waters Avenue, Suite 830 Tampa, FL 33634 P 813-221-0050 F 813-221-0051 terracon.com Geotechnical • Environmental Construction Materials Facilities 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 TABLE OF CONTENTS Page 1.0 INTRODUCTION 1 1.1 Project Objective 1 2.0 FIELD ACTIVITIES - ASBESTOS 2 2.1 Visual Assessment 2 2.2 Physical Assessment 2 2.3 Sample Collection 2 2.4 Sample Analysis 2 3.0 REGULATORY OVERVIEW - ASBESTOS 3 4.0 FINDINGS AND RECOMMENDATIONS — ASBESTOS 4 5.0 HAZARDOUS MATERIALS INVENTORY 5 5.1 Visual Observation 5 5.2 Regulatory Overview 6 5.3 Findings & Recommendations 6 6.0 FIELD ACTIVITIES LEAD — BASED PAINT 6 6.1 Visual Observation 7 6.2 Visual Assessment 7 6.3 Sample Analysis 7 7.0 REGULATORY OVERVIEW — LEAD-BASED PAINT 7 8.0 FINDINGS AND RECOMMENDATIONS — LEAD-BASED PAINT... 8 9.0 GENERAL COMMENTS 10 APPENDIX A SUMMARY OF ASBESTOS -CONTAINING MATERIAL SAMPLE LOCATIONS APPENDIX B SUMMARY OF LEAD-BASED PAINT SAMPLE LOCATIONS APPENDIX C ASBESTOS ANALYTICAL LABORATORY DATA APPENDIX D LEAD ANALYTICAL LABORATORY DATA APPENDIX E SITE PLAN AND PHOTOGRAPHS APPENDIX F CERTIFICATIONS AND LICENSES PRE -DEMOLITION NESHAP ASBESTOS SURVEY, LEAD-BASED PAINT SURVEY AND HAZARDOUS MATERIALS SURVEY REPORT Northeast Wastewater Treatment Facility State Road 580 and McMullen Booth Road Clearwater, Florida 33761 Terracon Project No. H4167137 January 19, 2017 1.0 INTRODUCTION Terracon conducted a pre -demolition NESHAP asbestos survey, lead-based paint and hazardous materials survey of client designated items at the Northeast Wastewater Treatment Facility located at State Road 580 and McMullen Booth Road in Clearwater, Florida: The survey was conducted on January 05, 2017 by Terracon's State of Florida accredited asbestos building inspector and EPA certified lead inspector Mr. Peter MacKay (certificate Nos. 170538-5886 & FL -I-118220-2, respectively) in accordance with Terracon's revised proposal number PH4150101 dated December 06, 2016. Building components were surveyed and homogeneous areas of suspect asbestos -containing materials (ACM) and lead-based paint (LBP) components were visually identified and documented. Additionally, potentially hazardous materials were inventoried that may be recycled and / or require modified disposal procedures related to the planned renovations/demolition of the designated structures. Although reasonable effort was made to survey accessible suspect materials, additional suspect but un -sampled materials could be located in walls, in voids, below the ground or in other concealed areas. The designated suspect ACM samples were collected in general accordance with the sampling protocols outlined in EPA regulation 40 CFR 763 (Asbestos Hazard Emergency Response Act, AHERA). Asbestos samples were delivered to an accredited laboratory for analysis. Suspect ACM samples were analyzed by Polarized Light Microscopy. Lead—based paint chip samples were obtained only from the designated representative surfaces potentially containing lead-based coatings. Potentially Hazardous Materials were visually observed but with no samples obtained. 1.1 Project Objective We understand this survey was requested to identify and locate ACM, LBP and Hazardous Materials prior to the proposed future renovation or demolition activities of the respective designated structures. The asbestos NESHAP (40 CFR Part 61, Subpart M) regulates asbestos fiber emissions and asbestos waste disposal practices. The NESHAP regulation also requires the identification and classification of existing ACM according to friability prior to the disturbance activities. In addition, asbestos and/or lead-based components are subjected to other regulations including the Responsive • Resourceful • Reliable 1 1 1 Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility Clearwater, Florida January 19, 2017 Terracon Project No. H4167137 lrerracon Occupational Safety and Health Administration (OSHA) and State of Florida. Terracon also performed a visual survey and documented observed potential PCB Tight ballasts and electrical transformers, and potential mercury containing thermostat switches and fluorescent light bulbs, batteries and high intensity lights, etc., or other items that might be considered as hazardous or regulated. 2.0 FIELD ACTIVITIES - ASBESTOS The survey was conducted by Mr. Peter MacKay, a State of Florida accredited asbestos inspector. The survey was conducted in general accordance with the sample collection protocols established in EPA regulation 40 CFR 763, the Asbestos Hazard Emergency Response Act (AHERA). A summary of survey activities is provided below. 2.1 Visual Assessment Our survey activities began with visual observations of the designated areas to identify homogeneous areas of suspect ACM. A homogeneous area consists of building materials that appear similar throughout in terms of color, texture and date of application. The interior assessment was conducted throughout visually accessible areas of the designated areas. Building materials identified as glass, wood, masonry, metal or rubber were not considered suspect ACM. 2.2 Physical Assessment A physical assessment of each homogeneous area of suspect ACM was conducted to assess the friability and condition of the materials. A friable material is defined by the EPA as a material which can be crumbled, pulverized or reduced to powder by hand pressure when dry. Friability was assessed by physically touching suspect materials. 2.3 Sample Collection Based on results of the visual observation, bulk samples of suspect ACM were collected in general accordance with AHERA sampling protocols. Random samples of suspect materials were collected in each homogeneous area. Samples were placed in sealable containers and labeled with unique sample numbers using an indelible marker. Forty-eight (48) bulk samples were collected from twenty-four (24) homogeneous areas of suspect ACM. A summary of suspect ACM samples collected during the survey is included as Appendix A. Responsive • Resourceful • Reliable Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility a Clearwater, Florida January 19, 2017 a Terracon Project No. H4167137 2.4 Sample Analysis lierracon Bulk samples were submitted under chain of custody to Cates Laboratories, Inc. (Cates) for analysis by Polarized Light Microscopy per EPA methodology EPA/600/R-93/116. The percentage of asbestos, where applicable, was determined by microscopic visual estimation or point counting. Cates is accredited under the National Voluntary Laboratory Accreditation Program (NVLAP Accreditation No. 200569-0). 3.0 REGULATORY OVERVIEW - ASBESTOS The asbestos NESHAP (40 CFR Part 61, Subpart M) regulates asbestos fiber emissions and asbestos waste disposal practices. The NESHAP regulation also requires the identification and classification of existing ACM according to friability prior to demolition or renovation activity. Under NESHAP, asbestos -containing building materials are classified as: 1. Friable ACM, or 2. Category I Non -Friable ACM, or 3. Category II Non -Friable ACM. Friable materials are those that, when dry, may be crumbled, pulverized or reduced to powder by hand pressure. Category I Non -Friable ACM includes packings, gaskets, resilient floor coverings and asphalt roofing products containing more than 1°/0 asbestos. Category II Non -Friable ACM are any materials other than Category I Non -Friable ACM that contain more than 1% asbestos. Under NESHAP, Regulated Asbestos -Containing Materials (RACM are classified as: 1. Friable ACM, 2. Category I Non -Friable ACM that is in poor condition and/or has become friable, 3. Category I Non -Friable ACM that will or has been subjected to sanding, grinding, cutting or abrading 4. Category II Non -Friable ACM that has a high probability of becoming or has become crumbled, pulverized or reduced to powder by the forces expected to act upon the material in the course of renovation or demolition operations. In the State of Florida, asbestos activities are regulated by the Florida Department of Environmental Protection (FDEP). Some counties have developed an enforcement division to carry out the responsibilities of the FDEP and have developed environmental and asbestos ordinances in which additional compliance is required. Since the facility is located in Pinellas County Florida, the NESHAP regulations are under the jurisdiction of the Pinellas County, Air Quality Division, who have enacted the Code of Ordinances, Part II, Chapter 58-145, et al., to additionally delineate their asbestos program requirements. Responsive ■ Resourceful • Reliable 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility a Clearwater, Florida January 19, 2017 i Terracon Project No. H4167137 lierracon Per the NESHAP, RACM must be removed prior to activities that will disturb the materials. Removal of the ACM or RACM must be conducted by a State of Florida -licensed asbestos abatement contractor, in compliance with Florida Statute (F.S) 469.001-014. In addition, third party air monitoring should be performed during and following the abatement. The Occupational Safety and Health Administration (OSHA) Asbestos standard for construction (29 CFR 1926.1101) regulates employee workplace exposure to asbestos. The OSHA standard has (2) Permissible Exposure Limits (PEL) that require employee exposure to airborne asbestos fibers be maintained below 0.1 asbestos fibers per cubic centimeter of air (0.1 f/cc) for an 8 -hour Time - Weighted Average (8 -Hr. TWA) and 1.0 f/cc for a 30 -minute TWA (Excursion Limit. The OSHA standard classifies construction and maintenance activities which could disturb ACM, and specifies work practices and precautions which employers must follow when engaging in each class of regulated work. 4.0 FINDINGS AND RECOMMENDATIONS - ASBESTOS Below is a list of materials that were found to contain asbestos. TABLE 1 HA Material Description Material Location Percent NESHAP CATEGORY Estimated Quantities 1l MS2 Pipe Gasket on 6" Pipe — Flange (Dark Green)Non-Friable Primary Pump House 35% Chrysotile Category! 15 SF MS4 Pipe Gasket on 10" Pipe — Valve Flange (Yellow) Primary Pump House 35% -Chrysotile Category I - Non -Friable 30 SF MS6 Caulking (Off -White) Primary Pump House — North & South Tank ° 3% - Chrysotile Category II - Non -Friable 10 SF R2 Pitch Pan Tar (Black) Irrigation System— — Roof 5% - Chrysotile Category 1 - Non Friable 20 SF (1) Estimated Quantities are approximate and not intended or developed for bidding or notification, etc., purposes and are to be confirmed prior to any such usage. Pipe Gaskets (Green & Yellow): These materials, in their current state, are considered to be a Category I non -friable material. The asbestos containing materials identified during this survey should be removed from the structure prior to demolition activities in accordance with applicable provisions for Class II asbestos work, by a Florida Licensed Asbestos Abatement Contractor Caulking (Off -White): This material, in its current state, can be considered to be a Category II non -friable material. The asbestos containing materials identified during this survey should be removed from the structure prior to renovation activities in accordance with applicable provisions for OSHA Class II asbestos work, by a Florida Licensed Asbestos Abatement Contractor. Responsive ■ Resourceful • Reliable Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility E Clearwater, Florida January 19, 2017 Terracon Project No. H4167137 lrerracon Roofing Materials — Pitch Pans: Asbestos -containing roofing materials (Pitch Pans) were identified as ACM. In its current state this material is categorized as Category I Non -Friable ACM by the EPA/NESHAP that appeared to be in good condition. If subjected to aggressive removal activities they could become RACM and should be removed as such by a Florida Licensed Asbestos Abatement Contractor prior to disturbance activities. Additionally, as a minimum, their removal would be considered an OSHA Work Class II activity, subject to specialized work practices, controls, etc. Overview Recommendations: Terracon recommends that the materials identified as containing asbestos be removed by a Florida -Licensed Asbestos Abatement Contractor prior to the demolition of the structure. Generally stated, the NESHAP requires notification to the local regulatory agency ten (10) working days prior to abatement activities if the any of the following threshold quantities of RACM are impacted: (1) 260 linear feet of piping, or (2) 160 square feet of other RACM, or (3) 35 cubic feet of debris. For demolition projects, the notification is required prior to all disturbance of ACM even in buildings with no asbestos present. Notification is typically sent electronically. The remediation contractor may need to wait ten (10) working days (Monday — Friday) from the date of notification before starting any disturbance activities. Any change to the start date of the disturbance requires notification to the agency by phone, followed by a written revision to the Notification Form. We also recommend direct contact with the Pinellas Air Quality Division (727.464.4422) for confirmation and clarifications of their asbestos program requirements. A summary of the classification and approximate quantity of identified ACM is presented in Table 1. The summary of sample locations is presented in Appendix A. Laboratory analytical reports are included in Appendix C. Terracon can provide the Client with a proposal for developing asbestos abatement specifications (project design) and for performing abatement oversight and air monitoring upon request. 5.0 HAZARDOUS MATERIALS INVENTORY Potentially hazardous materials observed within the designated structures at the facility were inventoried by Terracon representative Mr. Pete MacKay. 5.1 Visual Observations Our survey activities included a visual observation of each designated structure and an inventory of their respective suspect hazardous / regulated materials, if identified. Hazardous / regulated materials may include items that may be recycled or disposed of prior to demolition such as used Responsive ■ Resourceful 2 Reliably 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility a Clearwater, Florida January 19, 2017 a Terracon Project No. H4167137 lrerracon tires, computer monitors, treated power transmission poles, suspect polychlorinated biphenyl (PCB) and mercury -containing materials, used oils, batteries, and other materials such as electronics and certain fire suppression systems. This assessment was conducted throughout visually accessible interior and exterior areas of the designated structures. Our services did not include the collection of samples of suspect hazardous / regulated materials. Exhibits (Site Plans) presenting building locations are presented in Appendix E. Selected photographs are presented in Appendix E. 5.2 Regulatory Overview The United States Environmental Protection Agency (USEPA) regulates bulk PCB product waste under 40 Code of Federal Regulations (CFR) 761.62 of the Toxic Substances Control Act (TSCA). Certain mercury -containing equipment is covered under the Universal Waste regulation (40 CFR 273.9); other mercury wastes are regulated under the Resource Conservation and Recovery Act (RCRA) and are considered hazardous if the waste exceeds the toxicity characteristic leacheate procedure (TCLP) level of 0.2 milligrams per liter (mg/L) for mercury. State of Florida hazardous materials regulations are addressed in Florida Administrative Code (FAC) rule 63.730- Hazardous Waste. Equipment such as transformers may contain mineral oil with minor amounts of PCBs and could be considered "PCB contaminated" (PCB content 50-500 ppm). Under Florida law, it is illegal to discard nickel / cadmium or lead / acid batteries as trash; the batteries must be recycled or sent to a facility permitted to dispose of those batteries. The generator is responsible for compliance with applicable regulations regarding hazardous waste disposal. 5.3 Findings and Recommendations Structure Hazardous Materials Identified Primary Pump House None North Tank and South Tank None Head Works — Sludge Thickener None Grit Pumps — Lower Level None Electrical Motor Control Center None Irrigation System Tank — Chlorine Feed System One (1) Transformer Two (2) Generator Batteries Terracon identified one pad -mounted electric transformer at the southeast corner of the Irrigation System building. The transformers appeared in fair condition and no evidence of leakage of fluids was observed Responsive • Resourceful ■ Reliable Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility a Clearwater, Florida January 19, 2017 a Terracon Project No. H4167137 lierracon in association with the transformers. If this equipment will not be reused, Terracon recommends that the transformer be removed and properly disposed of prior to demolition activities in accordance with Federal, state, and local regulations. Additionally, two (2) acid batteries associated with the generator were observed in the vicinity of the chlorine feed system room. The acid batteries must be recycled or sent to an EPA certified waste disposal facility. 6.0 FIELD ACTIVITIES — LEAD-BASED PAINT SURVEY The lead-based paint survey was conducted by EPA accredited Lead Based Paint Inspector Mr. Peter MacKay (Accreditation No. FL -I-118220-2). A summary of survey activities is provided below. 6.1 Visual Observation This limited LBP screening was limited to readily observable and accessible surfaces. Terracon cannot guarantee a building or property to be LBP free as the possibility exists that LBP coated surfaces may be hidden from sight or in inaccessible locations, or the homogeneous construction areas identified may not be truly homogeneous. This LBP survey was not performed to the HUD Guidelines for the Evaluation and Control of Lead Containing Paint Hazards in Housing standards. It should be understood that this LBP survey is not considered to be comprehensive in nature, and the results are not intended to be used to determine lead hazards, develop abatement plans, or prepare detailed cost estimates for abatement. 6.2 Visual Assessment A visual assessment of each unique combination of suspect LBP was additionally conducted to assess the condition of the paint. A suspect LBP testing combination was defined as a component/substrate and color. The condition of the paint was documented to be intact, fair, and poor. 6.3 Sample Analysis Terracon performed a lead based paint (LBP) survey that consisted of collecting forty-two (42) paint chip samples from various painted components. Paint chip samples were submitted under chain of custody to EMSL Analytical Inc. for analysis by flame atomic absorption spectrometry per EPA SW-846/3050B/7000B. EMSL is accredited under the Environmental Lead Laboratory Accreditation Program (ELLAP) (ELLAP Accreditation No. 163563). Responsive ■ Resourceful • Reliable 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility • Clearwater, Florida January 19, 2017 a Terracon Project No. H4167137 7.0 REGULATORY OVERVIEW - LEAD BASED PAINT lrerracon Lead is regulated by the EPA, HUD, FDEP and OSHA. The EPA and FDEP regulate lead use, removal, and disposal, and OSHA regulates lead exposure to workers. The EPA defines LBP as paint, varnish, stain, or other applied coating that contains lead equal to or greater than 1.0 mg/cm2, 5,000 mg/kg, or 0.5% by dry weight as determined by laboratory analysis. For the purpose of the OSHA lead standard, lead includes any detectable concentrations of metallic lead, all inorganic lead compounds, and organic lead soaps. A synopsis of the OSHA regulations (29 CFR 1926.62) and the applicability are as follows: The OSHA Lead Standard for Construction (29 CFR 1926.62) applies to all construction work where an employee may be occupationally exposed to lead. All work related to construction, alteration, or repair (including painting and decorating) is included. The lead -in -construction standard applies to any detectable concentration of lead in paint, as even small concentrations of lead can result in unacceptable employee exposures depending upon on the method of removal and other workplace conditions. Under this standard, construction includes, but is not limited to, the following: • Disturbance or salvage of structures where lead or materials containing lead are present • Removal or encapsulation of materials containing lead New construction, alteration, repair, or renovation of structures, substrates, or portions containing lead, or materials containing lead • Installation of products containing lead Lead contamination/emergency clean-up Transportation, disposal, storage, or containment of lead or materials containing lead on the site or location at which construction activities are performed Maintenance operations associated with construction activities described above 8.0 FINDINGS AND RECOMMENDATIONS - LEAD BASED PAINT Based on a review of the analytical results, lead concentrations were detected in twenty-two (22) of the forty-two (42) paint chip samples collected during the survey. The results of components with documented lead levels are presented in Table 2.0. Whole architectural component removal is the recommended removal method to reduce the potential creation of hazardous waste. However, disturbance of coatings containing detectable levels of lead would be subjected to the requirements of the OSHA 29 CFR 1926.62 controls, training, etc. A summary of the samples and their results is presented in the following tables. Laboratory analytical reports are included as Appendix D. Responsive • Resourceful ■ Reliable Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility a Clearwater, Florida January 19, 2017 • Terracon Project No. H4167137 lierracon Components with Detectable Levels of Lead TABLE 2.0 Sample ID Sample location Component Color Substrate Lab Results (% by weight) Condition (Intact, Fair, or Poor) LBP -1 Primary Pump House - 1FL - Pipe, 10" Pipe Yellow Metal 3.4 Poor LBP -3 Primary Pump House - 1FL - Pipe, 6" Pipe Green Metal 0.034 Poor LBP -4 Primary Pump House - 1FL - Valve, 6" Valve Green Metal 0.053 Poor LBP -6 Primary Pump House - 1FL - Pump #2 - Valve Valve Red Metal 1.5 Poor LBP -7 Primary Pump House - 1 FL - Sludge Pump #1 Pump Light Blue Metal 0.11 Poor LBP -11 Primary Pump House - 1FL - Stairs Step Yellow Concrete 4.5 Poor LBP -13 Primary Pump House - North Tank - Drive Motor Motor Red Metal 0.015 Poor LBP -21 Headworks - Lower Level - Grit Pumps - Pipe, 6" Pipe Green Metal 0.013 Poor LBP -22 Headworks - Lower Level - Grit Pumps - Pipe, 6" Pipe Black Metal 0.018 Poor LBP -24 Headworks - Lower Level - Grit Pump - Pipe, 36" Pipe Gray Metal 0.038 Poor LBP -26 Irrigation System - Reclaimed Water Pump #2 Pump Gray Metal 0.72 Fair LBP -29 Irrigation System - Reclaimed Water - Electric Panel Cabinet Doors Gray Metal 0.47 Poor LBP -30 Irrigation System - Reclaimed Water - Storage Box Lid/Cover Gray Metal 0.060 Poor LBP -31 Irrigation System - Reclaimed Water- Natural Gas Pipeline, 3" Pipe Orange Metal 2.5 Poor LBP -33 Irrigation System - Reclaimed Water - Pump #2 Motor Dark Gray Metal 0.27 Poor LBP -34 Irrigation System - Reclaimed Water - Wall Wall Light Yellow Concrete 0.010 Poor LBP -35 Irrigation System - Reclaimed Water - Roof Support Beam Beam Yellow Wood 0.062 Poor LBP -36 Irrigation System - Reclaimed Water - Overhead PVC Drain Pipe, 2" Pipe Yellow PVC 6.3 Poor LBP -37 Irrigation System - Chlorine Feed System Room Wall White CMU 0.031 Fair LBP -38 Irrigation System - Chlorine Feed System Room Wall Gray CMU 0.021 Fair LBP -39 Irrigation System - Chlorine Feed System Room Door Frame Yellow Metal 0.030 Poor LBP -41 Irrigation System - Chlorine Feed System Room - Conduit Pipe Pipe Yellow Metal 0.030 Poor Responsive • Resourceful ■ Reliable 111111 UN NE M- -- MN N NS M- 11111 w OM NM NM NM I 1 1 1 Pre -demolition NESHAP Asbestos Survey, Lead -Based Paint and Hazardous Materials Survey Northeast Wastewater Treatment Facility a Clearwater, Florida January 19, 2017 a Terracon Project No. H4167137 lierracon Disturbance of any of the materials and/or components found to contain detectable levels of lead would require such activities be conducted in compliance with the requirements of the OSHA standard. As such, personnel disturbing materials/components would need to have the OSHA level required training, comply with the work practices, levels of potential exposure documented and compared to the Action and Permissible Levels of 30 ug/m3and 50 ug/m3 respectively. In addition, disposal of the waste materials would be tested utilizing the Toxicity characteristic leaching procedure (TCLP) to document lead content and compared to the EPA and FDEP threshold of 5.0 mg/Liter and disposed of accordingly. 9.0 GENERAL COMMENTS This pre -demolition NESHAP asbestos, lead-based paint and hazardous materials survey was conducted in a manner consistent with the level of care and skill ordinarily exercised by members of the profession currently practicing under similar conditions in the same locale. The results, findings, conclusions and recommendations expressed in this report are based on conditions observed during our survey of the building. The information contained in this report is relevant to the date on which this survey was performed, and should not be relied upon to represent conditions at a later date. This report has been prepared on behalf of and exclusively for use by King Engineering Associates, Inc. This report is not a bidding document. Contractors or consultants reviewing this report must draw their own conclusions regarding further investigation or remediation deemed necessary. Terracon does not warrant the work of regulatory agencies, laboratories or other third parties supplying information which may have been used in the preparation of this report. No warranty, express or implied is made. Responsive ■ Resourceful • Reliable APPENDIX A SUMMARY OF ASBESTOS CONTAINING MATERIALS SAMPLE LOCATIONS 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 M N NM MI M I N OM M IIIIII 111111 IIIIII IIIIII M I IIIII 1 APPENDIX A SUMMARY OF ASBESTOS CONTAINING MATERIAL SAMPLE LOCATIONS Northeast Wastewater Treatment Facility, Clearwater, FL HA No. Sample Number Location Material Description Size/Color Lab Results (p MS1 1 Primary Pump House, Flange Gasket Material 10" Pipe (Black/Painted Yellow) None Detected 2 Primary Pump House, Flange Gasket Material None Detected MS2 3 Primary Pump House, Flange Gasket Material 6" Pipe (Dark Green) 35% - Chrysotile 4 Primary Pump House, Flange Gasket Material 35% - Chrysotile MS3 5 Primary Pump House, Flange Gasket Material 10" Pipe (Red) None Detected 6 Primary Pump House, Flange Gasket Material None Detected MS4 7 Primary Pump House, Valve Flange Gasket Material 10" Pipe (Yellow) 35% - Chrysotile 8 Primary Pump House, Valve Flange Gasket Material 35% - Chrysotile MSS 9 Primary Pump House, North tank (tank wall) Concrete Yellow None Detected 10 Primary Pump House, South tank (tank wall) Concrete None Detected MS6 11 Primary Pump House, North Tank Caulking Off -White 3% Chrysotile 12 Primary Pump House, South Tank Caulking 3% Chrysotile MS7 13 North Tank, outer Ring Black Coating Black None Detected 14 North Tank, outer Ring Black Coating None Detected MSS 15 Sludge Thickener, Flange Valve Gasket Material 10" Flange Valve (Black) None Detected 16 Sludge Thickener, Valve Gasket Material None Detected MS9 17 Sludge Thickener, Flange Gasket Material 6" 10" (Brown) None Detected 18 Sludge Thickener, Cyclone Plug Valve Flange Gasket Material None Detected MS10 19 Pickett Thickener, Tank 1 Wall Concrete Yellow None Detected 20 Pickett Thickener, Tank 4 Wall Concrete None Detected MS11 21 Headworks (LL) Grit Pump Room, Flange Pipe 3 Gasket Material Black (Painted Yellow) None Detected 22 Headworks (LL) Grit Pump Room, Pump 1 — Pipe Flange Gasket Material None Detected MS12 23 Headworks (LL) Grit Pump Room, Pump 4 Flange Gasket Material 10" Pipe (Red) None Detected 24 Headworks (LL) Grit Pump Room, Pump 2 Flange Gasket Material None Detected Cl 25 Electrical Motor Control Room Ceiling Tile 2'x2' (Fissure, small & Medium Pinhole) None Detected 26 Electrical Motor Control Room Ceiling Tile None Detected MS13 27 Pipe Flange Headworks (LL) Room Gasket Material 36" Pipe (Gray) None Detected 28 Pipe Flange Headworks (LL) Room Gasket Material None Detected MS14 29 Irrigation System, Pump 3 Vibration Dampener 18" Pipe (Gray) None Detected 30 Irrigation System, Pump 2 Vibration Dampener None Detected MS15 31 Irrigation System, Pump 4 Gasket Material 18" Pipe (Red/Painted Purple) None Detected 32 Irrigation System, Pump 4 Gasket Material None Detected MS16 33 Irrigation System, Pump 2 Concrete Slab N/A None Detected 34 Irrigation System, Generator 1 Concrete Slab None Detected Responsive • Resourceful ■ Reliable 12 APPENDIX A SUMMARY OF ASBESTOS CONTAINING MATERIAL SAMPLE LOCATIONS NORTHEAST WASTEWATER TREATMENT FACILITY, CLEARWATER, FL HA No. Sample Number Location Material Description Component Layer Lab Results (I) MS17 35 Irrigation System, Slab South Side Concrete Slab N/A None Detected 36 Irrigation System, Chlorine Feed System Room Concrete Slab None Detected Rl 37 Irrigation System Roof Rolled Roofing Gra y None Detected 38 Irrigation System Roof Rolled Roofing None Detected 39 Irrigation System Roof Roofing Mastic Pitch Pan (Black) 5% Chrysotile 40 Irrigation System Roof Roofing Mastic 5% Chrysotile MS18 41 Tank Wall Concrete N/A None Detected 42 Tank Wall Concrete None Detected 43 Irrigation System, Chlorine Feeder Room Roof Rolled Roofing /Gravel None Detected 44 Irrigation System, Chlorine Feeder Room Roof Rolled Roofing None Detected MS19 45 Chlorine Feeder Room — Block Wall Concrete Block Filler/Texture None Detected 45 Chlorine Feeder Room — Block Wall Concrete Block CMU Block None Detected 45 Chlorine Feeder Room — Block Wall Concrete Block Mortar None Detected 46 Chlorine Feeder Room — Block Wall Concrete Block Filler/Texture None Detected 46 Chlorine Feeder Room — Block Wall Concrete Block CMU Block None Detected 46 Chlorine Feeder Room — Block Wall Concrete Block Mortar None Detected MS20 47 Effluent Pump House Caulking N/A None Detected 48 Effluent Pump House Caulking None Detected Responsive ■ Resourceful • Reliable 13 NM N 1111 an V MI M i 11111 MI I M M = M MI M I W NB I NM I N N all 11111 11111 11111— M N EN 11111 111111 APPENDIX B SUMMARY OF LEAD-BASED PAINT SAMPLE LOCATIONS Northeast Wastewater Treatment Facility, Clearwater, FL Sample ID Sample location Component Color Substrate Lab Results (% by weight) Condition (Intact, Fair, or Poor) LBP -1 Primary Pump House — 1FL — Pipe, 10" Pipe Yellow Metal 3.4 Poor LBP -2 Primary Pump House — 1FL — Valve, 10" Valve Yellow Metal <0.010 Poor LBP -3 Primary Pump House — 1FL — Pipe, 6" Pipe Green Metal 0.034 Poor LBP -4 Primary Pump House — 1FL — Valve, 6" Valve Green Metal 0.053 Poor LBP -5 Primary Pump House — 1FL — Pump #1 Pump Red Metal <0.016 Poor LBP -6 Primary Pump House — 1FL — Pump #2 — Valve Valve Red Metal 1.5 Poor LBP -7 Primary Pump House — 1FL — Sludge Pump #1 Pump Light Blue Metal 0.11 Poor LBP -8 Primary Pump House — 1FL — Sludge Pump #2 Valve Dark Blue Metal <0.014 Poor LBP -9 Primary Pump House — 1FL — Sludge Pump #1 Motor Slab Silver Metal <0.010 Poor LBP -10 Primary Pump House — IFL — Wall Wall Yellow Concrete <0.010 Poor LBP -11 Primary Pump House — 1FL — Stairs Tread Yellow Concrete 4.5 Poor LBP -12 Primary Pump House — South Tank (North Side) Wall Yellow Concrete <0.010 Poor LBP -13 Primary Pump House — North Tank — Drive Motor Motor Red Metal 0.015 Poor LBP -14 Primary Pump House — North Tank — Sump Pump Outer Ring Black Metal <0.010 Poor LBP -15 Primary Pump House — Pickett Thickener Tank #3 Wall Yellow Concrete <0.010 Fair LBP -16 Primary Pump House — Pickett Thickener Tank #1 Drive Motor Green Metal <0.010 Poor LBP -17 Primary Pump House — Pickett Thickener Tank #3 Drive Motor Blue Metal <0.010 Poor LBP -18 Primary Pump House — Pickett Thickener - Feeder Pipe, 10" Pipe Black Metal <0.010 Fair LBP -19 Primary Pump House — Pickett Thickener - Feeder Pipe, 6" Pipe Brown Metal <0.010 Fair LBP -20 Headworks — Lower Level — Grit Pumps — Pipe, 10" Pipe Tan Metal <0.010 Poor LBP -21 Headworks — Lower Level — Grit Pumps — Pipe, 6" Pipe Green Metal 0.013 Poor LBP -22 Headworks — Lower Level — Grit Pumps — Pipe, 6" Pipe Black Metal 0.018 Poor LBP -23 Headworks — Lower Level — Grit Pumps — Pump Pump Blue Metal <0.010 Poor LBP -24 Headworks — Lower Level — Grit Pump — Pipe, 36" Pipe Gray Metal 0.038 Poor LBP -25 Headworks — Lower Level — Grit Pump Room — Wall Wall Yellow Concrete <0.010 Poor LBP -26 Irrigation System — Reclaimed Water Pump #2 Pump Gray Metal 0.72 Fair LBP -27 Irrigation System — Reclaimed Water — Pump #4 Pump Purple Metal <0.010 Fair LBP -28 Irrigation System — Reclaimed Water — Generator Pump Green Metal <0.010 Poor LBP -29 Irrigation System — Reclaimed Water — Electric Panel Cabinet Doors Gray Metal 0.47 Poor LBP -30 Irrigation System — Reclaimed Water — Storage Box Lid/Cover Gray Metal 0.060 Poor LBP -31 Irrigation System — Reclaimed Water — Natural Gas Pipeline, 3" Pipe Orange Metal 2.5 Poor Responsive • Resourceful • Reliable 14 APPENDIX B SUMMARY OF LEAD-BASED PAINT SAMPLE LOCATIONS Northeast Wastewater Treatment Facility, Clearwater, FL Sample ID Sample location Component Color Substrate Lab Results (% by weight) Condition (Intact, Fair, or Poor) LBP -32 Irrigation System — Reclaimed Water— Roof Support Post Post Yellow Metal <0.010 Poor LBP -33 Irrigation System — Reclaimed Water — Pump #2 Motor Dark Gray Metal 0.27 Poor LBP -34 Irrigation System — Reclaimed Water — Wall Wall Light Yellow Concrete 0.010 Poor LBP -35 Irrigation System — Reclaimed Water — Roof Support Beam Beam Yellow Wood 0.062 Poor LBP -36 Irrigation System — Reclaimed Water — Overhead PVC Drain Pipe, 2" Pipe Yellow PVC 6.3 Poor LBP -37 Irrigation System — Chlorine Feed System Room Wall White CMU 0.031 Fair LBP -38 Irrigation System — Chlorine Feed System Room Wall Gray CMU 0.021 Fair LBP -39 Irrigation System — Chlorine Feed System Room Door Frame Yellow Metal 0.030 Poor LBP -40 Irrigation System — Chlorine Feed System Room Door Yellow Metal <0.024 Poor LBP -41 Irrigation System — Effluent Pump — Electrical Conduit Pipe Yellow Metal 0.030 Poor LBP -42 Irrigation System — Effluent Feed System — Lift Pipe White Metal <0.010 Poor Note: Bolded entries indicate detectable levels of lead & regulated by OSHA Responsive ■ Resourceful • Reliable 15 N M IIIIII M O MI M M MI IIIIII M I MI OM M OM APPENDIX C ASBESTOS ANALYTICAL LABORATORY DATA PLM REPORT SUMMARY Cates Laboratories NVLAP Lab No. 200569-0 ig1339 Motor Circle TDSHS License No. 30-0287 Dallas, Texas 75207 (214) 920-5006 Client: Terracon Lab Job No.: PLM-13606 Project: Northeast Wastewater Treatment Facility, S.R. 580 & McMullen Booth Rd. Set No.: 20437 Project No: H4167137 Report Date: 1/11/2017 Identification: Asbestos, Bulk Sample Analysis Sample Date: 1/5/2017 Test Method: Polarized Light Microscopy/Dispersion Staining (PLM/DS) EPA Method 600/R-93/116 Page 1 of 4 On 1/9/2017, forty-eight (48) bulk samples were submitted by Mr. Pete MacKay of Terracon for asbestos analysis by PLM/DS. Copies of the lab data sheets are attached; additional information may be found therein. The results are summarized below: Lab Sample No. Client Field I.D. Sample Description/Location Asbestos Content CL503437 CL503438 CL503439 CL503440 CL503441 CL503442 CL503443 CL503444 CL503445 CL503446 CL503447 CL503448 CL503449 CL503450 CL503451 CL503452 CL503453 CL503454 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Pipe Gasket on 10" Pipe (black, painted yellow) - Primary Pump House, Flange Pipe Gasket on 10" Pipe (black, painted yellow) - Primary Pump House, Flange Pipe Gasket on 6" Pipe (dark green) - Primary Pump House, Flange Pipe Gasket on 6" Pipe (dark green) - Primary Pump House, Flange Pipe Gasket on 10" Pipe (red, black gasket) - Primary Pump House, Flange Pipe Gasket on 10" Pipe (red, red gasket) - Primary Pump House, Flange Pipe Gasket on 10" Pipe (yellow) - Primary Pump House, Valve Flange Pipe Gasket on 10" Pipe (yellow) - Primary Pump House, Valve Flange North Tank Concrete Wall (yellow) - Primary Pump House, North tank (tank wall) South Tank Concrete Wall (yellow) - Primary Pump House, South tank (tank wall) Off-white Caulking - Primary Pump House, North Tank Off-white Caulking - Primary Pump House, South Tank North Tank (black coating) - North Tank, outer Ring North Tank (black coating) - North Tank, outer Ring Pipe Gasket 10" (black) - Sludge Thickener, Flange Valve Pipe Gasket 10" (black) - Sludge Thickener, Valve Pipe Gasket 6"-10" (brown) - Sludge Thickener, Flange Pipe Gasket 6"-10" (brown) - Sludge Thickener, Cyclone Plug Valve Flange None Detected None Detected 35% Chrysotile 35% Chrysotile None Detected None Detected 35% Chrysotile 35% Chrysotile None Detected None Detected 3% Chrysotile 3% Chrysotile None Detected None Detected None Detected None Detected None Detected None Detected I These samples were analyzed by layers. The overall percent asbestos for the sample is reported when relevant. The EPA considers a material to be asbestos containing only if it contains greater than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials that are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. CatesLab utilizes CVAE on a routine basis and does not include point counting unless specifically requested by the client. The results may not be reproduced except in full. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 PLM REPORT SUMMARY Cates Laboratories NVLAP Lab No. 200569-0 4g1339 Motor Circle TDSHS License No. 30-0287 Dallas, Texas 75207 (214) 920-5006 Client: Terracon Lab Job No.: PLM -13606 Project: Northeast Wastewater Treatment Facility, S.R. 580 & McMullen Booth Rd. Set No.: 20437 Project No: H4167137 Report Date: 1/11/2017 Identification: Asbestos, Bulk Sample Analysis Sample Date: 1/5/2017 Test Method: Polarized Light Microscopy/Dispersion Staining (PLM/DS) EPA Method 600/R-93/116 Page 2 of 4 On 1/9/2017, forty-eight (48) bulk samples were submitted by Mr. Pete MacKay of Terracon for asbestos analysis by PLM/DS. Copies of the lab data sheets are attached; additional information may be found therein. The results are summarized below: Lab Sample No. Client Field I.D. Sample Description/Location Asbestos Content CL503455 CL503456 CL503457 CL503458 CL503459 CL503460 CL503461 CL503462 CL503463 CL503464 CL503465 CL503466 CL503467 CL503468 CL503469 CL503470 CL503471 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Tank Wall Concrete (yellow) - Pickett Thickener, Tank 1 Wall Tank Wall Concrete (yellow) - Pickett Thickener, Tank 4 Wall 10" Pipe Gasket (black, painted yellow) - Headworks (LL) Grit Pump Room, Flange Pipe 3 10" Pipe Gasket (black, painted yellow) - Headworks (LL) Grit Pump Room, Pump 1 Pipe Flange 10" Pipe Gasket (red) - Headworks (LL) Grit Pump Room, Pump 4 Flange 10" Pipe Gasket (red) - Headworks (LL) Grit Pump Room, Pump 2 Flange 2' X 2' Ceiling Tile (fissure & small/medium pinhole) - Electrical Motor Control Room 2' X 2' Ceiling Tile (fissure & small/medium pinhole) - Electrical Motor Control Room Pipe Gasket 36" (grey) - Pipe Flange Headworks (LL) Room Pipe Gasket 36" (grey) - Pipe Flange Headworks (LL) Room 18" Pipe Damper (grey) - Irrigation System, Pump 3 18" Pipe Damper (grey) - Irrigation System, Pump 2 18" Pipe Gasket flange (red, painted purple) - Irrigation System, Pump 4 18" Pipe Gasket flange (red, painted purple) - Irrigation System, Pump 4 Concrete Foundation (equipment foundation) - Irrigation System, Pump 2 Concrete Foundation (equipment foundation) - Irrigation System, Generator 1 Concrete Foundation Slab - Irrigation System, Slab South Side None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected None Detected These samples were analyzed by layers. The overall percent asbestos for the sample is reported when relevant. The EPA considers a material to be asbestos containing only if it contains greater than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials that are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. CatesLab utilizes CVAE on a routine basis and does not include point counting unless specifically requested by the client. The results may not be reproduced except in full. Cates 1339 PLM REPORT SUMMARY Laboratories NVLAP Lab No. 200569-0 Motor Circle TDSHS License No. 30-0287 Texas 75207 (214) 920-5006 Dallas, Client: Terracon Lab Job No.: PLM -13606 Project: Northeast Wastewater Treatment Facility, S.R. 580 & McMullen Booth Rd. Set No.: 20437 Project No: H4167137 Report Date: 1/11/2017 Identification: Asbestos, Bulk Sample Analysis Sample Date: 1/5/2017 Test Method: Polarized Light Microscopy/Dispersion Staining (PLM/DS) EPA Method 600/R-93/116 Page 3 of 4 On 1/9/2017, forty-eight (48) bulk samples were submitted by Mr. Pete MacKay of Terracon for asbestos analysis by PLM/DS. Copies of the lab data sheets are attached; additional information may be found therein. The results are summarized below: Lab Sample No. Client Field I.D. Sample Description/Location Asbestos Content CL503472 CL503473 CL503474 CL503475 CL503476 CL503477 CL503478 CL503479 CL503480 CL503481 CL503482 CL503483 CL503484 36 37 38 39 40 41 42 43 44 45 46 47 48 Concrete Foundation Slab - Irrigation System, Chlorine Feed System Room Rolled Roofing (grey) - Irrigation System Roof Rolled Roofing (grey) - Irrigation System Roof Pitch Pan Tar (black) - Irrigation System Roof Pitch Pan Tar (black) - Irrigation System Roof Poured Concrete - Tank Wall Poured Concrete - Tank Wall Rolled Roofing w/Gravel - Irrigation System, Chlorine Feeder Room Roof Rolled Roofing w/Gravel - Irrigation System, Chlorine Feeder Room Roof Block Wall - Chlorine Feeder Room Block Wall - Chlorine Feeder Room Caulking Material - Effluent Pump House Caulking Material - Effluent Pump House None Detected None Detected None Detected 5% Chrysotile 5% Chrysotile None Detected None Detected None Detected None Detected None Detected - Filler/Texture None Detected - CMU Block None Detected - Mortar None Detected - Filler/Texture None Detected - CMU Block None Detected - Mortar None Detected None Detected These samples were analyzed by layers. The overall percent asbestos for the sample is reported when relevant. The EPA considers a material to be asbestos containing only if it contains greater than one percent asbestos by Calibrated Visual Area Estimation (CVAE). EPA regulations also indicate that Regulated Asbestos Containing Materials (RACM) — materials that are friable or may become friable — be further analyzed by point counting when the results indicate less than ten percent asbestos by CVAE. CatesLab utilizes CVAE on a routine basis and does not include point counting unless specifically requested by the client. The results may not be reproduced except in full. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 PLM REPORT SUMMARY gCates Laboratories 1339 Motor Circle Dallas, Texas 75207 (214) 920-5006 NVLAP Lab No. 200569-0 TDSHS License No. 30-0287 Client: Project: Project No: Identification: Test Method: Terracon Northeast Wastewater Treatment Facility, S.R. 580 & McMullen Booth Rd. H4167137 Asbestos, Bulk Sample Analysis Polarized Light Microscopy/Dispersion Staining (PLM/DS) EPA Method 600/R-93/116 Lab Job No.: PLM -13606 Set No.: 20437 Report Date: 1/11/2017 Sample Date: 1/5/2017 Page 4 of 4 On 1/9/2017, forty-eight (48) bulk samples were submitted by Mr. Pete MacKay of Terracon for asbestos analysis by PLM/DS. Copies of the lab data sheets are attached; additional information may be found therein. STATEMENT OF LABORATORY ACCREDITATION The samples were analyzed in general accordance with the procedures outlined in the Method for the Determination of Asbestos in Bulk Building Materials, EPA/600/R-93/116 or the U.S. Environmental Protection Agency method, under AHERA (EPA 600/M4-82-020), for the analysis of asbestos in building materials by polarized light microscopy. The results of each bulk sample relate only to the material tested and the results shall not be used by the client to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the Federal Government. Specific questions concerning bulk sample results shall be directed to the Laboratory Director. Analyst: Kathy Schosek Laboratory Director: John R. Cates, P.G. Approved Signatory: C764 --e a�a NVLAP LAB CODE 200569-0 1 APPENDIX D LEAD - ANALYTICAL LABORATORY DATA 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 '" "'"• 200 Route 130 North, Cinnaminson, NJ 08077 Phone/Fax: (856) 303-2500 / (856) 786-5974 EMSL Analytical, Inc. http://www.EMSL.com cinnaminsonleadlabno emsl.com I Attn: Pete MacKay EMSL Order: 201700157 CustomerlD: TERA72 CustomerPO: H4167137 Project) D: Terracon Consultants, Inc. 5463 West Waters Avenue Suite 830 Tampa, FL 33634 IProject: H4167137 'Client Sample Description Phone: (813) 626-1730 Fax: (813) 626-1452 Received: 01/09/17 10:30 AM Collected: Test Report: Lead in Paint Chips by Flame AAS (SW 846 3050B/7000B)* Lab ID Collected Analyzed Lead Concentration LBP -1 IBP -2 201700157-0001 1/11/2017 Site: Primary Pump House 10" Pipe 3.4 % wt 201700157-0002 1/11/2017 Site: Primary Pump House 10" Valve <0.010 % wt IBP -3 LBP -4 IBP -5 201700157-0003 1/11/2017 Site: Primary Pump House 6" Pipe 0.034 % wt 201700157-0004 1/11/2017 Site: Primary Pump House 6" Valve 0.053 % wt 201700157-0005 1/11/2017 Site: Primary Pump House Pump 1 <0.016 % wt LBP -6 1EF-7 201700157-0006 1/11/2017 Site: Primary Pump House Pump 2 Valve 1.5 %wt 201700157-0007 1/11/2017 Site: Primary Pump House Sludge Pump 1 Valve 0.11 % wt BP -8 BP -9 201700157-0008 1/11/2017 Site: Primary Pump House Sludge Pump 2 Valve <0.014 % wt 201700157-0009 1/11/2017 Site: Primary Pump House Sludge Pump 1 Motor Slab IBP -10 201700157-0010 1/11/2017 Site: Primary Pump House Wall <0.010 % wt <0.010 % wt LBP -11 201700157-0011 1/11/2017 Site: Primary Pump House Stairs 1BP-12 201700157-0012 1/11/2017 Site: South Tank Wall 4.5 % wt <0.010 % wt IBP -13 201700157-0013 1/11/2017 Site: North Tank Drive Motor BP -14 201700157-0014 1/11/2017 Site: North Tank Outer Ring 0.015 % wt <0.010 % wt ,BP -15 201700157-0015 1/11/2017 Site: Sludge Thickener Room, Tank 3 Wall 1 1 <0.010 % wt Phillip Worby, Lead Laboratory Manager or other approved signatory ( *Analysis following Lead in Paint by EMSL SOP/Determination of Environmental Lead by FLAA. Reporting limit is 0.010 % wt based on the minimum sample weight per our SOP. Unless noted, results in this report are not blank corrected. This report relates only to the samples reported above and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities. Samples received in good condition unless otherwise noted. "<" (less than) result signifies that the analyte was not detected at or above the reporting limit. Measurement of uncertainty is available upon request. The QC data associated with the sample results included in this report meet the recovery and precision requirements unless specifically indicated otherwise. Definitions of modifications are available upon request. Samples analyzed by EMSL Analytical, Inc. Cinnaminson, NJ NELAP Certifications: NJ 03036, NY 10872, PA 68-00367, AIHA-LAP, LLC ELLAP 100194, A2LA 2845.01 Initial report from 01/12/2017 11:18:45 •est Report ChmSnglePrm/nQC-7.32.3 Printed: 1/12/2017 11:18:45 AM Page 1 of 3 EMSL Analytical, Inc. 200 Route 130 North, Cinnaminson, NJ 08077 Phone/Fax: (856) 303-2500 / (856) 786-5974 http://www.EMSL.com cinnaminsonleadlab(a�emsl.com Attn: Pete MacKay Terracon Consultants, Inc. 5463 West Waters Avenue Suite 830 Tampa, FL 33634 Project: H4167137 EMSL Order: 201700157 CustomerlD: TERA72 CustomerPO: H4167137 Projectl D: Phone: (813) 626-1730 Fax: (813) 626-1452 Received: 01/09/17 10:30 AM Collected: Test Report: Lead in Paint Chips by Flame AAS (SW 846 3050B/7000B)* Client Sample Description Lab ID Collected Analyzed Lead Concentration LBP -16 201700157-0016 1/11/2017 Site: Sludge Thickener Room, Tank 1 Drive Body <0.010 % wt LBP -17 201700157-0017 1/11/2017 Site: Sludge Thickener Room, Tank 3 Drive Body <0.010 % wt LBP -18 201700157-0018 1/11/2017 Site: Sludge Thickener Room- Feeder Pipe <0.010 % wt LBP -19 201700157-0019 1/11/2017 Site: Sludge Thickener Room Pipe Raw Sewage <0.010 % wt LBP -20 201700157-0020 1/11/2017 Site: Headworks Lower Level Grit Pipes <0.010 % wt LBP -21 201700157-0021 1/11/2017 Site: Headworks Lower Level Grit Pipes 0.013 % wt LBP -22 201700157-0022 1/11/2017 Site: Headworks Lower Level Grit Pumps Pipes 0.018 % wt LBP -23 201700157-0023 1/11/2017 Site: Headworks Lower Level Grit Pumps Pipes <0.010 % wt LBP -24 201700157-0024 1/11/2017 Site: Headworks Lower Level Grit Pumps Room 0.038 % wt LBP -25 201700157-0025 1/11/2017 Site: Headworks Lower Level Grit Pumps Room <0.010 % wt LBP -26 201700157-0026 1/11/2017 Site: Irrigation System Reclaimed Water Pump 2 0.72 % wt LBP -27 201700157-0027 1/11/2017 Site: Irrigation System Reclaimed Water Pump 4 <0.010 % wt LBP -28 201700157-0028 1/11/2017 Site: Irrigation System Reclaimed System Generator <0.010 % wt LBP -29 LBP -30 201700157-0029 1/11/2017 Site: Irrigation System Reclaimed System- Electrical Panel Cabinet 201700157-0030 1/11/2017 Site: Irrigation System Reclaimed System- Storage Box 0.47 °/0 wt 0.060 % wt Phillip Worby, Lead Laboratory Manager or other approved signatory 'Analysis following Lead in Paint by EMSL SOP/Determination of Environmental Lead by FLAA. Reporting limit is 0.010 % wt based on the minimum sample weight per our SOP. Unless noted, results in this report are not blank corrected. This report relates only to the samples reported above and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities. Samples received in good condition unless otherwise noted. "<^ (less than) result signifies that the analyte was not detected at or above the reporting limit. Measurement of uncertainty is available upon request. The QC data associated with the sample results included in this report meet the recovery and precision requirements unless specifically indicated otherwise. Definitions of modifications are available upon request. Samples analyzed by EMSL Analytical, Inc. Cinnaminson, NJ NELAP Certifications: NJ 03036, NY 10872, PA 68-00367, AIHA-LAP, LLC ELLAP 100194, A2LA 2845.01 Initial report from 01/12/2017 11:18:45 Test Report ChmSnglePrm/nQC-7.32.3 Printed: 1/12/2017 11:18:45 AM Page 2 of 3 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Attn: 1 EMSL Analytical, Inc. 200 Route 130 North, Cinnaminson, NJ 08077 Phone/Fax: (856) 303-2500 / (856) 786-5974 http://www.EMSLcom cinnaminsonleadlab(a)emsl.com Pete MacKay Terracon Consultants, Inc. 5463 West Waters Avenue Suite 830 Tampa, FL 33634 Project: H4167137 Phone: Fax: Received: Collected: EMSL Order: 201700157 CustomerlD: TERA72 CustomerPO: H4167137 ProjectlD: (813) 626-1730 (813) 626-1452 01/09/17 10:30 AM Tient Sample Description Lab ID Collected Analyzed Test Report: Lead in Paint Chips by Flame AAS (SW 846 3050B/7000B)* Lead Concentration LBP -31 IBP -32 201700157-0031 1/11/2017 Site: Irrigation System Reclaimed System- Natural Gas Line 2.5 % wt 201700157-0032 1/11/2017 Site: Irrigation System Reclaimed System- Roof Support Post <0.010 % wt IBP -33 LBP -34 201700157-0033 1/11/2017 Site: Irrigation System Reclaimed System Pump 2 Motor 0.27 % wt 201700157-0034 1/11/2017 Site: Irrigation System Reclaimed System Wall I.BP -35 201700157-0035 1/11/2017 Site: Irrigation System Reclaimed System Roof Support Beam LBP -36 201700157-0036 1/11/2017 Site: Irrigation System Reclaimed System PVC Pipe Drain 2" 0.010 % wt 1 -BP -37 0.062 % wt 6.3 % wt 201700157-0037 1/11/2017 Site: Chlorine Feed System Room 0.031 % wt 11BP-38 201700157-0038 1/11/2017 Site: Chlorine Feed System Room 0.021 % wt BP -39 201700157-0039 1/10/2017 Site: Chlorine Feed System Room �BP 40 201700157-0040 1/10/2017 Site: Chlorine Feed System Room 0.030 % wt <0.024 % wt LBP -41 201700157-0041 1/10/2017 Site: Effluent Chlorine Feed System IBP -42 201700157-0042 1/10/2017 Site: Effluent Chlorine Feed System 0.030 % wt <0.010 % wt 1 1 1 1 Phillip Worby, Lead Laboratory Manager or other approved signatory I*Analysis following Lead in Paint by EMSL SOP/Determination of Environmental Lead by FLAA. Reporting limit is 0.010 % wt based on the minimum sample weight per our SOP. Unless noted, results in this report are not blank corrected. This report relates only to the samples reported above and may not be reproduced, except in full, without written approval by EMSL. EMSL bears no responsibility for sample collection activities. Samples received in good condition unless otherwise noted. "<" (less than) result signifies that the analyte was not detected at or above the reporting limit. Measurement of uncertainty is available upon request. The QC data associated with the sample results included in this report meet the recovery and precision requirements unless specifically indicated otherwise. Definitions of modifications are available upon request. Samples analyzed by EMSL Analytical, Inc. Cinnaminson, NJ NELAP Certifications: NJ 03036, NY 10872, PA 68-00367, AIHA-LAP, LLC ELLAP 100194, A2LA 2845.01 Initial report from 01/12/2017 11:18:45 lest Report ChmSnglePrm/nQC-7.32.3 Printed: 1/12/2017 11:18:45 AM Page 3 of 3 APPENDIX E SITE PLANS & PHOTOGRAPHS Eli UM O I M- ! I I I- 1- 1 N OM r N I I Project Manager: RES Drawn by: PM Checked by: RES Approved by: RES Project: H4167137 Scale: NTS File Name: Date: 1/13/2017 lierracon 5436 W. Waters Ave., Suite 830 Tampa, Florida 33634 SAMPLE LOCATION DIAGRAM Primary Pump House & Headworks Sludge Thickener Northeast Wastewater Treatment Facility S.R. 580 + McMullen Booth Road Safety Harbor, Florida 34695 Exhibit 1 LBP -26 LBP -29 LBP -30 LBP -31 LBP -33 LBP -35 LBP -36 Project Manager: RFS Drawn by: PM Checked by: RES Approved by: RES Project: H4167137 Scale: NTS File Name: Date: 1/13/2017 lierracon 5436 W. Waters Ave., Suite 830 Tampa, Florida 33634 SAMPLE LOCATION DIAGRAM Irrigation System - Reclaimed Water Northeast Wastewater Treatment Facility S.R. 580 + McMullen Booth Road Safety Harbor, Florida 34695 Exhibit 2 NM M M OM NM I i- i-- M I I E I OM M N APPENDIX F CERTIFICATIONS AND LICENSES STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ASBESTOS LICENSING UNIT LICENSE NUMBER ZA 337 The ASBESTOS BUSINESS ORGANIZATION Named below IS LICENSED Under the provisions of Chapter 469 FS. Expiration date: NOV 30, 2017 TERRACON CONSULTANTS INC MICHAEL W SCHRUM 1675 LEE ROAD WINTER PARK FL 32789 EixomixTie STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ASBESTOS LICENSING UNIT The ASBESTOS CONSULTANT- ENGINEE Named bolo* IS LICENSED Linder the F•0411•04$ 04 Chapter 460 FS. Expirat-co date- NOV 30, 2018 STAUFFER, RUSSELL E TERRACON CONSULTANTS, INC 54]'NEST WAIERS AVENUE 4430 TAMPA FL 33634 UFTREE° Center UNIVERSITY of FLORIDA Center for Training, Research and Education for Environmental Occupations certifies Peter C. MacKay Cts. Irtc, 934 1:T0ft .1 11. In. DWI p1WSI 15-1E1(113Get *saga aiib a om• 701, sr !gybes has sacomatult, rott trith33132 requirtmema far Asbestos Refresher: inspector Teefl 1,517.Z. 1,k...1N Pmylder ICCC0995, Caw.. (12,0-0,101731 ;Y. X.r; 3 4F1 t.,7*.ct igiaccradifartlan for Inspector uvular TSCA Tit. IIVAHERA) Conduerearl 0812412016 Vallicste 4: 110332-M4 Emir Disc iiiiiVI4e2016 EPA aertofixistAsks cgsires: 01.14.181 7 PYirocied iitsinectsr, /Wpm Dirrisrut, PE, LAC CELL; _4 ESP! fAC: 04901:1611.1; Ohms $09474711 EWE PEW,aam ri411Re *moon 'Etireantlowor bitiactu lath University of Fit:1444S TREED Center • !WO SW 63 Boakiaal • 352.3924SM • www.uctuultedu Terracon Consultants Inc. has rwsned the requremants of the Toxic Suttstancea Conti W.Ac[ (TSCA) Section 402, and has recenoed centrvtion: to conduct lead -basad paIM acthnhes pursuant to 40 CFR Part 745.226 Florida This cartificat n,s valid from the date of *seance add expires May 24, 2017 FL -2606-4 Certification A July 30, 2014 Issued On Michelle Price, Chief Lead, Heavy Metals, and Inorganics Branch Peter Christian MacKay has fulfilled the requirements of the Toxic Substances Control Aci 1TSSCAI Seclicn 402, and has received certification to arndtict iead-based paint activities pursuant to 40 CFR Pat 745226 es - Florida This r ertid`cahn is valid from the date ct issuance and e FL -I-118220-2 Certification # April 24, 2014 Issued On January 1 Adrienne Priselac, Manager, Toxics Office Land Division CI?IIYOFCLEARWATER Date: February 3, 2021 Project: NE WRF Improvements RE -BID For: All concerned parties I`,' (,i\I:r:RING DEPART \tl:\`i' MUNICIP 11 SERVICIIs BUILDING, 100 S. N11.11 AVENI l Cr.h RW ATE, FWrtuD. 33'56 Tlwz(727) 562-4750 FAX (727) 562-4755 PUBLIC NOTICE ADDENDUM ONE NOTICE IS HERBY GIVEN that the following addendum serves to provide clarification on the scheduled dates for the NE WRF Improvements RE -BID bid opening. The City of Clearwater invitation to bid web page https://www.myclearwater.com/Home/Components/RFP/RFP/262/2511 has been updated to reflect the bid opening date that was posted in the Tampa Bay Times on January 27, 2021. INVITATION TO BID NOTICE TO CONTRACTORS NE WRF Improvements RE -BID Documents and plans for Project NE WRF Improvements RE -BID #19 -0029 -UT are available at https://www.myclearwater.com/businessfengineering-construction-bids. The work includes modifications to existing grit and primary treatment and sludge blend and storage systems, and new flow equalization system at the City's Northeast Water Reclamation Facility (WRF). Pre -Bid Meeting: February 12, 2021 at 9:30AM Meeting Location Information: https://www.myclearwater.com/business/invitation-to-bid Pre -qualification Application Submittal DEADLINE: February 17, 2021 Category: Wastewater Treatment Facility Pre -qualification Amount: $19,000,000.00 Bids DUE: March 3, 2021 at 2:OOPM (EST) Bid Opening: March 3, 2021 at 2:OOPM (EST) Meeting Location Information: https://www.myclearwater.com/business/invitation-to-bid FedEx or Drop off bids to: City of Clearwater, Attn: Lori Vogel Mark Bunker, Councilmember Kathleen Beckman, Councilmember Frank David Allbritton. Councilmember l loyt Hamilton, Councilmember Equal Employment and Afftrmatire Action Employer" Project # 19 -0029 -UT Procurement Office, 3rd Floor 100 S. Myrtle Ave, Clearwater, FL 33756-5520 Issued by Lori Vogel, CPPB, Procurement Manager For additional information contact Engineering Dept.: 727-562-4750 END OF NOTICE CITYOF'CLARWATFR Date: February 22, 2021 Project: NE WRF Improvements RE -BID For: All concerned parties ENGINEERING DEPARTMENT MUNICIPAL SERVICES BUILDING, 100 S. MYRTLE AVENUE CLEARWATF-R FLORIDA 33756 TELEPHONE (727) 562-4750 FAx (727) 562-4755 PUBLIC NOTICE ADDENDUM TWO NOTICE IS HERBY GIVEN that the following addendum serves to provide clarification on the scheduled date and time for an optional, secondary site visit. February 24, 2021 10:00 AM (EST) Northeast Water Reclamation Facility 3290 State Road 580 Safety Harbor, FL 34695 Please email Duy.Nguyen@myclearwater.com if you have any questions. Mark Bunker, Councilmember Kathleen Beckman, Councilmember END OF NOTICE •rank Hibbard, Mayor David Allbritton, Councilmember Hoyt I larnilton, Councilmember "Equal Employment and Affirmative Action Employer" CONTRACT DOCUMENTS FOR NE WRF IMPROVEMENTS PROJECT PROJECT #19 -0029 -UT FOR CITY OF CLEARWATER ADDENDUM NO. 3 Date Issued: February 25, 2021 Bidders on this project are hereby notified that Addendum No. 1 shall be attached to and made part of the above-named Bid Documents, dated January 2021. The following items are issued to add to, modify, and clarify the Bid Documents. These items shall have full force and effect as the Bid Documents, and the cost involved shall be included in the various prices bid. Bids, to be submitted on the specified bid date, shall conform to the additions and revisions listed herein. IN THE SPECIFICATIONS IN SECTION IIIA: 1. PART 24 - CONTRACT TIMES AND LIQUIDATED DAMAGES CHANGE Paragraph 24.2.1 on Page 2 to read as follows: "24.2.1 Contractor shall achieve Substantial Completion of the Work within seven hundred (700) days from the date on which Owner issues Contractor a Notice to Proceed." 2. PART 24 CONTRACT TIMES AND LIQUIDATED DAMAGES CHANGE Paragraph 24.3.1 on Page 3 to read as follows: "24.3.1 Contractor shall achieve Final Completion of the Work within seven hundred Thirty (730) days from the date on which Owner issues Contractor a Notice to Proceed." Addendum No. 3 Page 1 of 4 IN SECTION IVA: 3. SECTION 01005 GENERAL REQUIREMENTS DELETE Lines 25 through 38 on Page 01005-7. 4. SECTION 01016 CONSTRUCTION PHASING PLAN CHANGE Line 39 on Page 01016-2 to read as follows: "two systems is not occurring concurrently. The Contractor will be allowed to perform work related to the non-operating sludge thickeners in the Headworks Building provided there are no disruptions to any existing plant operations or functions." 5. SECTION 01030 SPECIAL PROJECT PROCEDURES CHANGE Line 14 on Page 01030-9 to read as follows: "shall be filled and tested for leaks by the Contractor with water in accordance with Section 03800. The Owner will make reclaimed water available for testing. The Contractor shall furnish all labor, materials and piping/valves necessary to convey the water from the source to the point of need. The Contractor shall perform all leakage testing in a manner acceptable to" 6. SECTION 01150 MEASUREMENT AND PAYMENT CHANGE Line 1 on Page 01150-8 to read as follows: "All demolition work, including all hazardous waste materials abatement; as specified, shown or required" IN SECTION IVB: 7. SECTION 02140 TEMPORARY DEWATERING ADD the following to Line 40 on Page 02140-2: "J. Should a gravel blanket be found while demolishing the existing irrigation tank for construction of the new Equalization Basin, the Contractor shall remove the gravel drainage blanket if satisfactory compaction cannot be attained." 8. SECTION 13615 PROCESS INSTRUMENTATION AND EQUIPMENT CHANGE Lines 28 and 29 on Page 13615-11 to read as follows: "F. Provide DC power supplies for devices as required, mounted in the associated control panel. Provide conduit and wire to device." Addendum No. 3 Page 2 of 4 9. SECTION 11324 MACERATOR CHANGE Line 7 on Page 11324 -3 to read as follows: "as manufactured by JWC Environmental, or Engineer -approved equal." 10. SECTION 15062 DUCTILE IRON PIPE AND FITTINGS ADD the following to Paragraph 3.02 N on page 16775-7, Line 46: "If requested by the Engineer, pipe spools fabricated with threaded flanges shall be pressure tested by the fabricator in the factory prior to delivery to the job site. The Engineer shall be given notice 5 -days prior to the fabrication of any pipe spool with threaded flanges. Furnish full diameter blind flanges tapped to introduce water for testing. Mount blind flange with gasket on pipe spool, fill spool with water and pressurize to pressure identified in Section 01625 or the ductile iron pipe specification. Provide Mega -flange, or equal, adaptors and blind flanges for testing spools where a plain end is required. Pressure testing shall be performed in accordance with Section 01625 and these specifications and shall show no leakage. Furnish written certification, in a format acceptable to the Engineer, attesting to the successful testing of each spool piece prior to delivery to the project site." IN SECTION IVC: 11. SECTION 03180 CONCRETE COATING SYSTEM CHANGE Paragraph 2.01 A.3 to read as follows: "3. Tnemec Series 436 Permashield FR a. Cementitious surfacer shall be Tnemec Series 218 and shall be applied at a minimum of 1/16 inch thickness and as required to bring the existing structure up to original thickness and to fill voids and bug holes to create a monolithic surface. b. Prime surfaces with Tnemec Series N69 at a minimum DFT of 6 mils. c. Apply one coating of Tnemec Series 436 Perma-Shield FR on surfaces at a minimum DFT of 100 to 110 mils." 12. SECTION 11356 PROGRESSIVE CAVITY PUMPS CHANGE Paragraph 2.01 C to read as follows: "C. Acceptable manufacturers: 1. Moyno Inc. 2. Engineer -approved equal." Addendum No. 3 Page 3 of 4 ON THE DRAWINGS 13. ADD the following Notes to Sht. G1.05: "Notes: The flow rate from the temporary grit tank to the 48" secondary influent shall be up to 18,750 gpm (27.0 mgd, 100%). The flow rate from the temporary grit tank to the moving belt filters shall be up to 3,400 gpm (4.9 mgd, 31 %). The Contractor will be allowed to hot tap the existing influent force mains at its own risk. The Contractor shall identify operational force mains. The Contractor will be allowed to work in non -operational thickeners in the Headworks Building provided such work does not affect any existing operations or functions." 14. ADD the following Note to Shts. C3.01, C3.02, C3.03 and 03.04: "Note: All new and replacement asphaltic concrete roadways shall consist of a 12" compacted subbase, 8" limerock base course and 2" asphaltic concrete surface course (SP 12.5)." 15. ADD the following Note to Sht. S3.00: "Note: The Contractor shall over excavate, backfill and compact that area extending 10 feet beyond the footprint of the new and existing tanks as indicated. This work does not need to extend to the new slab -on -grade area adjacent to the structure nor to the Electrical Building, unless within 10 feet of the tanks." Addendum No. 3 Page 4 of 4 CONTRACT DOCUMENTS ' FOR NE WRF IMPROVEMENTS PROJECT PROJECT #19 -0029 -UT FOR CITY OF CLEARWATER ADDENDUM NO. 4 Date Issued: February 26, 2021 Bidders on this project are hereby notified that Addendum No. 4 shall be attached to and made part of the above-named Bid Documents, dated January 2021. The following items are issued to add to, modify, and clarify the Bid Documents. These items shall have full force and effect as the Bid Documents, and the cost involved shall be ' included in the various prices bid. Bids, to be submitted on the specified bid date, shall conform to the additions and revisions listed herein. 1 IN THE SPECIFICATIONS IN SECTION IIIA: 1. ADD the following on Page 4/4: "8. Delete Paragraph 5.2.6 in its entirety and insert the following in its place: 1 5.2.6 BUILDER'S RISK INSURANCE The City will provide at its expense, Builder's Risk Insurance or other course of construction property insurance for the project to cover all risks of loss in the complete and full value of the project. Such insurance shall extend coverage to Contractors and subcontractors and materials in transit or temporary storage. Contractor agrees to cooperate in a timely manner with providing any information or documentation required for the application and by the policy carrier as the project proceeds." 1 Addendum No. 4 Page 1 of 2 IN SECTION IVA: 2. SECTION 01500 TEMPORARY FACILITIES CHANGE Line 9 on Page 01500-5 to read as follows: "PCs. The Contractor shall be responsible for installing and paying all charges associated with providing dedicated internet service to the site, separate from the Owner's current internet service. The use of a mobile, mini WIFI will not be acceptable. 13 Addendum No. 4 Page 2 of 2 SECTION V CONTRACT DOCUMENTS Table of Contents PUBLIC CONSTRUCTION BOND 1 CONTRACT 3 CONSENT OF SURETY TO FINAL PAYMENT 7 PROPOSAL/BID BOND 8 AFFIDAVIT 9 NON -COLLUSION AFFIDAVIT 10 PROPOSAL 11 CITY OF CLEARWATER ADDENDUM SHEET 13 BIDDER'S PROPOSAL 14 SCRUTINIZED COMPANIES AND BUSINESS OPERATIONS WITH CUBA AND SYRIA CERTIFICATION FORM 16 SCRUTINIZED COMPANIES THAT BOYCOTT ISRAEL LIST CERTIFICATION FORM 17 SECTION V Page i Updated: 5/4/2020 1 FRONT PAGE CONTRACTOR'S PERFORMANCE AND PAYMENT BOND (Public Work) Bond No.: Contractor Name: Contractor Address: Contractor Phone No.: Surety Company: Owner Name: Owner Address: Owner Phone No.: (If different from property Owner, or Dual Obligee) Obligee Address: Obligee Phone No.: Bond Amount: * 107423018/ K40300272 * Poole & Kent Company of Florida *1715 W. Lemon Street, Tampa, FL 33606 *813-251-2438 *Travelers Casualty and Surety Company of America Federal insurance Company *City of Clearwater, Florida *100 S. Myrtle Avenue Clearwater, FL 33756 *727-562-4747 *Same as above *Same as above * $18,437,514.70 Contract No. (if applicable) * Project No. 19 -0029 -UT Description of Work: * North East WRF Improvements Project Location: * City of Clearwater,. Florida Legal Description: * North East WRF Improvements, Project No. 19 -0029 -UT This.Bond has been fumished to comply with the requirements of F.S. 255.05. This.bond.is hereby amended.such.thatalt provisions and limitations, including conditions, notice and time limitations of F.S. 255.05 are incorporated herein by reference. Any provision of this bond which conflicts with or purports to grant broader or more expanded coverage in excess of the minimum of the applicable statute shall be deemed deleted herefrom. This bond is a statutory bond, not a common law bond_ This Is the front page of the Performance/Payment Bond(s) regardless of preprinted numbers on .other pages issued in compliance with Florida Statute 255.05. n(sharefbo ndslfrontpag 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 SECTION V — Contract Documents Bond No.; 107423018/ K40300272 PUBLIC CONSTRUCTION BOND (1) This bond is given to comply with § 255.05, Florida Statutes, and any action instituted by a claimant under this bond for payment must be in accordance with the notice and time limitation provisions in subsections (2) and (10). Pursuant to § 255.05(1)(b), Florida Statutes, "Before commencing the work or before recommencing the work after a default or abandonment, the contractor shall provide to the public entity a certified copy of the recorded bond. Notwithstanding the terms of the contract or any other law governing prompt payment for construction services. the public entity may not make a payment to the contractor until the contractor has complied with this paragraph.` CONTRACTOR Poole & Kent Company of Florida 1715 W. Lemon St. Tampa, FL 33606 813-251-2438 SURETY Travelers Casualty and Surety Company of America & Federal Insurance Company Iname] One Tower Square, Hartford, CT 06183 (TR) 202E Halls Mill Rd, Whitehouse Station, NJ 08889 (FE) principal business address] 732-321-5600 (TR), 908-605-3154(FE) [phone number] PROJECT NAME: North East WRF Improvements PROJECT NO.: 19 -0029 -UT OWNER City of Clearwater Engineering 100 S. Myrtle Avenue Clearwater, FL 33756 (727) 562-4750 PROJECT DESCRIPTION: modifications to existing grit and primary treatment and sludge blend and storage systems, and new flow equalization system at the City's Northeast Water Reclamation Facility (WRF). Travelers Casualty and Surety Company of America & BY THIS BOND, We, Poole & Kent Company of Florida as Contractor, and Federal Insurance Company , a corporation, as Surety, are bound to the City of Clearwater, Florida, herein called Owner, in the sum of $18,437,514.70, for payment of which we bind ourselves. our heirs. personal representatives, successors, and assigns, jointly and severally. THE CONDITION OF THIS BOND is that if Contractor: I. Performs the contract dated , between Contractor and Owner for construction of North East WRF Improvements, the contract documents being made a part of this bond by reference (which include the Advertisement for Bids, Proposal, Contract, Surety Bond, Instructions to Bidders, General Conditions, Plans, Technical Specifications and Appendix, and such alterations as may be made in said Plans and Specifications as therein provided for), at the times and in the manner prescribed in the contract; and 2. Promptly makes payments to all claimants, as defined in Section 255.05(1), Florida Statutes, supplying Contractor with labor, materials, or supplies, used directly or indirectly by Contractor in the prosecution of the work provided for in the contract; and SECTION V Page 1 of 17 Updated: 5/4/2020 ACTION V --Contract Documents Bond No.: 107423018/ K40300272 PUBLIC CONSTRUCTION BOND (2) 3. Pays Owner all losses. damages, expenses, costs, and attorney's fees, including appellate proceedings, that Owner sustains because of a default by Contractor under the contract: and 4. To the limits of § 725.06(2). Florida Statutes, shall indemnify and hold harmless Owner. their officers and employeesfrom liabilities, damages, losses and costs, including, but not limited toreasonable attorney's fees, to the extent caused by the negligencerecklessness, or intentional wrongful misconduct of Contractor and persons employed or utilized by Contractor in the performance of the construction contract: and Performs the guarantee of all work and materials furnished under the contract for the time specified in the contract, then this bond is void: otherwise it remains in full force. 6. Any action instituted by a claimant under this bond for payment must be in accordance with the notice and time limitation provisions in Section 255.05(2), Florida Statutes. 7. Any changes in or under the contract documents and compliance or noncompliance with any formalities connected with the contract or the changes does not affect Surety's obli tion under this bond, and Surety does hereby waive notice of any such change, extension of time, alteration or addition to the terms of the contract or to the work or to the specifications. IN TESTIMONY WHEREOF. witness the hands and seals of the parties hereto this 23rd day of April . 20 21. (If sole Chvnership or Partnership, two Witnesses required). (If Corporation, Secretary only will attest and tea seal). WITNESS: Corporate Secretary or itness Print Narne: David A. Strickland (affix corporate seal) SECTION V Poole & Ken By: Title: Print Name: any o Florida President & CEO Patrick H. Carr Print Nam,' Christi Travelers Casualty and Surety Company of America & Federal Insurance Company (Corporate Surety) 13y J ATTORNEY-IN-FACT Print Name; Camille Maitland Non Resident License #W012268 (affix corporate seal) (Power of Attorney must be attached) Page 2 of 17 Updated: 5/4/202 NIB 11111 111111 11111 NM NMI 111111 11111 NEI 11111 INN 111111 EN Ell FLORIDA DEPARTMENT OF FINANCIAL SERVICES CAMILLE M MAITLAND License Number : W012268 Non Resident Insurance License Issue Date .0920 - NONRES GEN LINES (PROP & CAS) 09/03/2010 Please Note: NOTICE - This non-resident license is limited to the classes of insurance reflected above and is further limited to ONLY those classes of insurance for which you are licensed in your home state. A licensee may only transact insurance with an active appointment by an eligible insurer or employer If you are acing as a surplus tines agent pubic ad(usler or reinsurance intermediary manager /broker. you should have an appointment recorded in your own name on the with the Department_ tf you we unsure of your Ireense latus you shouts contact the Florida Department of Finanual Services ,mmediately. This license will expire 4 more than 48 months elapse wahout an appointment for each class of insurance fisted. 8 such expiratmn occurs: the individual will be required to re -qualify as a first-time applicant. 8 this license was obtained by passing a licensure examination offered by the Florida Department of Financial Services, the licensee is required to comply with continus'tg education requirements contained in 528.2815 its 648 38S, F arida Statutes A licensee may hack their canfinuing education requirements completed or needed rn their MyProflle account al Mips //Woe fklis corn To validate the accuracy of this hoarse you may review the individual /:cense record under 'Licensee Search" on the Florida Department o! Financial Services website at http: lhvaw.MyFiore1aCFO com/Divnsion/Agents Jen' Atwater Chief l• financial Officer State of Florida TRAVELERS,: Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS' Thal Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St Paul Fire and Marine Insurance Company are corporations duly organized under the laws of the State of Connecticut (herein collectively called the "Companies"), and that the Companies do hereby make, constitute and appoint Camille Maitland of Uniondale.New York, their true and lawful Attomey-in-FaCt to Sign. execute, seat and acknowledge any and all bonds, recognizances, conditional undertakings and other writings oblgatory in the nature thereof on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law IN WITNESS WHEREOF, the Companies have caused this instrument to be signed, and their corporate seals to be hereto affixed, this 3rd day of February. 2017. State of Connecticut City of Hartford ss. By.A - Robert L. Raney. Serif& Vice President On this the 3rd day of February, 2017, before me personally appeared Robert L. Raney, who acknowledged himself to be the Senior Vice President of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, and that he, as such, being authorized so to do, executed the foregoing Instrument for the purposes therein contained by signing on behalf of the corporations by himself as a duly authorized officer In Witness Whereof, 1 hereunto set my harx1 and offiaal seal. My Commission expires the 30th day of June, 2021 C UTAtauit Marie C. Tetreautt Notary Public This Power of Attorney is granted under and by the authority of the following resolutions adopted by the Boards of Directors of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, which resolutions are now in full force and effect, reading as follows: RESOLVED, that the Chairman. the Presiden(, any Vice Chairman, any Executive Vice President, any Senior Vice President, any Vice President. any Second Vice President. the Treasurer, any Assistant Treasurer, the Corporate Secretary or any Assistant Secretary may appoint Attomeys-in-Fact and Agents to act for and on behalf of the Company and may give such appointee such authority as his or her certificate of authority may prescribe to sign with the Company's name and seal with the Companys seal bonds, recognizances, contracts of indemnity, and other writings obligatory in the nature of a bond, recognizance, or conditional undertaking, and any of said officers or the Board of Directors at any time may remove any such appointee and revoke the power given him or her, and it is FURTHER RESOLVED, that the Chairman, the President, any Vice Chairman, any Executive Vice President, any Senior Vice President or any Vice President may delegate alt or any part of the foregoing authority to one or more officers or employees of this Company, provided that each such delegation is in veiling and a copy thereof is tiled in the office of the Secretary: and is FURTHER RESOLVED, that any bond, recognizance, contract of indemnity, or writing obligatory in the nature of a bond, recognizance, or conditional undertaking shall be valid and binding upon the Company when (a) signed by the President, any Vice Chairman. any Executive Vice President, any Senior Vice President or any Vice President. any Second Vice President, the Treasurer, any Assistant Treasurer. the Corporate Secretary or any Assistant Secretary and duly attested and sealed with the Companys seal by a Secretary or Assistant Secretary; or (b) duty executed (under seal, if required) by one or more Attorneys -in -Fact and Agents pursuant to the power prescribed in his or her certificate or their centficates of authority or by one or more Company officers pursuant to a written delegation of authority; and it is FURTHER RESOLVED, that the signature of each of the following officers. President, any Executive Vice President, any Senior Vice President. any Vice President any Assistant Vice President, any Secretary, any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident Vice Presidents, Resident Assistant Secretaries or Attorneys -in -Fact for pu-poses onty of executing and attesting bonds and undertakings and other writings obligatory in the nature thereof. and any such Power of Attorney or certificate bearing such facsimile signature or facsimile seal shall be valid and binding upon the Company and any such power so executed and certified by such facsimile signature and facsimile seal shall be valid and binding on the Company in the future with respect to any bond or understanding to which it is attached. I, Kevin E. Hughes, the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America, Travelers Casualty and Surety Company, and St. Paul Fire and Marine Insurance Company, do hereby certify that the above and foregoing is a true and correct copy of the Power of Attorney executed by said Companies, which remains in full force and effect , Dated this 23rd day of April ,2021 Kevin E. Hughes, Ass tent Secretary To verify the authenticity of this Power of Attorney, please call us at 1-600-421-3880. Please refer to the above-named Attorney -in -Fact and the details of the bond to which the power is attached. State of Fien0C 206 On this day of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA flti o HARTFORD. CT 06183 PRIM EL'S ACKNOWLEDGMENT Id< 4-1.cAr.i in the year 20 3 1 . before mc. the undersigna personally appeared personally known to me or proved to me on the basis of satisfadory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her capacity, and that by his/her signature he instrument. the individual. or the person upon behalf of which the individual acted. executed the instrument SURETY COMPANIOS ACKNOWLEDGMENT State of NEW YORK . County of NASSAU Iss. On this 23rd_ day of April personally known to me. and Kings County, New York Notary Public in the year 20 21 before me. the undersigncd. personally appeared CaMille Maitland who. being by me duly sworn. did depose and say: That he/she resides in : that he/she is Attomcy-in-Fact of TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA. the corporation described in and which executed the within instrument that be/she knows the corporate seal of said Company; that the seal affixed to said instrument is such corporate seal; and that he/she signed said instrument as Attomey-in-Faci by authority of the Board of Directors of said Company: and affiant did further depose and say that the Superintendent of the State of New York Department of Financiai Services has. pursuant to Section 1111 of the New York Insurance Law. issued to TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA his/her certificate that said Company is qualified to become and be accepted as surety or guarantor on al! bonds, undertakings. reatimizances guaranties, and other obligations required or permitted by law: and that such certificate has not been revoked ALj 144 TRAVELERS CASUALTY AND SURETY COmPANY OF AMERICA HARTFORD. CONNECTICUT 06183 INANC1AL STATEMENT AS OF DECEMBER 31. 2020 AS FILED IN THE STATE OF NEWYORK CAPITAL STOCK 16.480,CCO ELLY RENCHIWICH Notary Public Notary Public, State of New York No. 01RE6218158 Qualified in Nassau County Commission Expires March 1, 2022 ..K,s 7E TS LIABILITIES & SURF1 CASH Al4D INVESTED CASH BONDS STOCKS 04VESt mENT INCOME DUE M0 ACCRULO OTHER INVESTED ASSETS PREMIUM BALANCES NET DEFERRED T AX ASSET FiEINSURANCE RECOVERABLE RECEIVABLES FROM PARENT, SUBSIDIARIES AND AFFILIATES OTHER ASSETS TOTAL ASSETS $ 239.403,348 3931156,061 109,074,035 36 856,7139 4371/512 277653,799 551I4,715 R553,518 34076.347 4155)94 1.1125.81AW„ UNEARNED PREMIUMS LOSSES LOSS ADJUS T MENT EXPENSES COMMISSIONS TAXES, MENSES AND FEES OTHER EYPENSES CURRENT FEDERAL AND FOREIGN INCOME TAXES REMITTANCES AND ITEMS NO I ALLOCATED AMOUNTS WITHHELD /RETAINED f3Y COMPANY FOR OTHERS POLICYHOLDER DIVIDENDS PROVISION FOR REINSURANCE ADVANCE PREMIUM CEDED REINSURANCE NET PREMIUMS PAYABLE RE I ROACT IVE REINSURANCE RESERVE ASSUMED THE R ACCRUED EXPENSES AND UABiuTIES TOTAL UABIUTIES CAPITAL STOCK PAID IN SURPLUS OTHER sortus TOTAL SURPLUS 10 POUCYROI TOTAL LIABILITIES 1. SUTWUJS 1,121,070,3130 1.0032130,666 163,346,678 49.935.693 13,561,421 42506359 4.935.184 8646,391 42Z28.250 12353.304 7.930.280 1,307512 53 102.971 800.763 568,668 2334,655 020 6,400.X0 433.933,760 1E50,750.947 2.091034,607 1 EHLJBB Power of Attorney Federal Insurance Company Vigilant Insurance Company ( Pacific Indemnity Company Westchester Fire Insurance Company I ACE American Insurance Company Know All by These Presents. that FEDERAL LNSURANCE COMPANY, an Indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation. PACIFIC INDEMNITY COMPANY, a Wisconsin corporation WESTCHESTER FIRE INSURANCE COMPANY and Act AMERICAN ISSURANCE COMPANY corporations of die Commonweal of Pennsylvania, do each hereby constitute and appoint Katherine Acosta, Thomas Bean, George 0. Brewster, Desiree Cardlln, Colette R. Chisholm, Dana Granice, Susan Lupskl, Gerard S. Macholz, Camille Maitland, Robert T. Pearson, Nelly RenchiwIch, Rita Losquadro, Vincent A. Walsh and Michelle VVa nnamaker of Uniondale, New York each as their true and lawful Attorney, in •Eact to execute under such designation in their !lames and to offla their corporate iwoli to and deliver for and on their behalf as a urerrtherenn or other...int, bonds and undertakings and other writings obligatory in the nature thereof (other than ball bonds) given or executed in the course of bitstness, and any instruments amending or Alen ng the same, and ronsents to the modif.catIon or alteration of any Instrument rehired to in said bonds on obtgartions. In Witnesa Whereof said FEDERAL INSURANCE COMPANY. VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY have each executed and attested these prevents and affixed du,,r corporate seals on this fite day of Intro ary, 2021. Qituisr-Ti\ Iwo Al TURIN Affitant STATE OF NEW (MISC.( 'ouity of Hunterdon .1,114,31 41 143114..1..4in: ivi..--4,141.11 On ties Rut day of Ditusary, 2021 before oe. a Notary Public of New icesey. personally came Dawn M Chlorin. and Stephen M. Haney. to me known to be Assistant Secretary and like Pr-ex:dent. respective/It O(FEDERAL 1NURM4� COMPANY, VIGILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY. WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY. thr companies %hut caroted the foregoing Power of Attorney, and the said Dawn P4. Odom and Stephen M Haney, being hy me duly sworn. sfverailv and each for herself and himself did depose and say that they are Assistant Secretary and Vice President respeedeely. of FEDERAL INSURANCE COMPANY. VICILANT INSURANCE COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE COMPANY and ACE AMERICAN INSURANCE COMPANY and know the corporate seals thereof that the seals affixed to the foregoing Power of Actomes are such corporate seals and were thereto affi wed by authertly of Said Companies, and that their signatures as such ofTecers were duly affixed and subscribed by like authority KA -INURING J. A0E-IAAR NOTARY Pt/81-10 OF NEW JERRKY No 2316666 Oornotisaann Liperos 2C24 mealy Nett I CERTIFICATION Ansel utcos adopted by the Boards of Directors of FEDERAL INSURANCE COMPANY. VIGILANT LNSURANf:E COMPANY, and PACIFIC IND NrrY COMPANY en August 30, 2016; WESTCHESTER FIRE INSURANCE CCIMPANY oo December 11, 2006; and ACE AMERICAN INSURANCE COMPANY on March 20, 2004 -iteSOLYED, that the hafloostrag althOrtsadollt ruble in de eseartgon, fee and oo behalf of the Company, al boodz node -n.51,1,4; log.bCatliawcor. Contracts snd edict ernarn arm miasma of the Cowpony •-•1L0rct noo in tie ordrenany came 4 Weenie feed 1-W210en COMM ItZ04%41. i it) exit of if* Chantron, the Prialionf and the 51. Presidents of ihe Company ro Meshy autbortr,A to yemotr Jur %woo° Cearrnaitmort for aod on Wulf of the Crroporty ,,odor de seal at the Company or otl:mytra. ei`r bath dolt/ appointed attorney ta-tert ed the Company is nrryinyernhartard to execute Any Writurta ( ocustrric At Wand an behalf of the Comp. r, under the meal of the Certinany or orlomolor. 0) the mete that such anew or 41.thnr10ms1 br Mx tram ai svagnaS prowtiM for . i ‘..I., norlooleli .trittan sqr paid. tent.na ...au. 14) Each of the Chednnau, Ir President and che vire Presidents of dm Coirtp.1, 12 1212647)' bighortfte, for scat on WWI' of the Company, to aopotot In ...Stine aaer pavan the owner -et fort af cbc Company old: AA proem and sotnarety teresucona for and oar behalf of the Comporry, rind. 20,' 'cold the Company or otherwise. suds Wrens, f amndernerm of the Compons i (4) OS Mar be tpeaUbtd to mid, wriftom App.:urea:at, ohith ipeoftcattormay he by prrirowi rep, or clan of Wrtiten CollITO,Mwnts V: by specifiraeon ur one Cr aeric particular written torrinutmenn WI of the Chairman the fresMena end the 51.-e Presiding" of Ilto Company ii P -P11.1.7 AtitilOrtrtd, for and on baball of elw Lompary. ha delegate In writing ro aoy odic officer of the Company the authority to meow. Mr and on behalf of the COSerarrg, soder the Comorany's soar rn ntherurno, sorb Yertnen CornmItmerns 04 011 Cobtporiy ..1 are ruertArd in such written delearoinh asharresificitlen may be by georro, tyro or dug el Wthien frammernents or try aseeibuineo atone or mors particular Wnnen Commiterrerm I(5) The signature of any eaten or 06<f eases ramenag my Mete Cornurue edt or sepoiettecat ix sielegauon purixoet to this Resolune. eanti the sail of the Company, may be affixed by Mannar an coda Written Caeoradauses or wnores oppruconoot or delergation FUF17-HER h1,301.1"Ell thAt the be emerrag Resolotrin shall mot bo delerned a 1 bc se cud AArYA stater.. of the powers aed authority of °Kowa amuck rem seed other rxrsrmu to *et for 004 00 betAlf 01 20., Company, 564 1000 Raawrium.. fAali OpIllnut or mama hp atom tbe ramewa or aay so12 poem. or authority ollyrrrtor ealtdly granted Of Mfiall.. I, Dawn M. Chloros. Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE. COMPANY, PACIFIC INDEMNITY COMPANY, WESTCHESTER FIRE INSURANCE I COMPANY and ACE AMERICAN INSURANCE COMPANY (tlse 'Companies') do hereby certify that (I) the foregoing Resolutions adopted by the Board of Directors of the Companies are true. correct and in toll force and effect, (o) the foreguing Power of Artorr.ey Is true, corrnit and In full farce and effect Given under my hand end seals of eaid Companies at Whitehouse Station. NI, this April 23, 2021 1 1 1 Davn h‘Aiwin 114 THE WEIR YOU WtoH TO eriatTY TUE AUTHENTIC fTY or run Mb OR Noon' us OF ANY4/TH£1414ATTEg. 1. hose arLa0.-4 EA. 4.544154M 00S4, meant ruresselkitobbnpot Cnnuttne.1 ICirav 11 lei LISAT ACKNOWLEDGMENT OF SURETY COMPANY STATE OF New York COUNTY OF Nassau On this April 23, 2021 , before me personally came Camille Maitland to me known, who, being by me duly sworn, did depose and say; that he/she resides in Kings County , State of New York that he/she is the Attomey-In-Fact of the Federal Insurance Company the corporation described in which executed the above instrument; that he/she knows the seal of said corporation; that the seal affixed to said instrument is such corporate seal; that is was so affixed by the Board of Directors of said corporation; and that he/she signed his/her name thereto by like order; and the affiant did further depose and say that the Superintendent of Insurance of the State of New York, has pursuant to Section 1111 of the Insurance Law of the State of New York, issued to Federal Insurance Company (Surety) his/her certificate of qualification evidencing the qualification of said Company and its sufficiency under any law of the State of New York as surety and guarantor, and the propriety of accepting and approving it as such; and that such certifi . to a not b • n revoked. Notary)6.Iic NY acknowledgement NELLY IN RENCHNViCH Watery Publia-Stata of New Yat/ Na. OI RE821816e Cualtfied in Nassau Commission Explras Ussch 1022 1 DccuSign Envelope ID 0B8.37366-A23A-4BAD-951D-3081981785F 2 FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES ANO SURPLUS TO POLICYHOLDERS Statutory Basis December 31. 2020 in thousands) ASSETS I Cash and Short Term investments United States Government,State Si (247647) and Municipal Bonds 4,277,332 Other Bonds 5,455,272 Stocks 567,632 1 Other Invested Assets 1,207,053 TOTAL INVESTMENTS 11,269,842 I investments in Affiliates Great Northern Ins Co Vigilant Ms Co 404,669 349,615 Chubb Indemnity Iris Cc, 182,191 Chubb National Ms Co 188,189 Other Andiates 98,626 Premiums Receivable 1,634,609 Other Assets 2,410691 1 sr9 "ZAT/.8 Vice President TOTAL ADMITTED ASSETS $ 16 527 052 UABILIRES ANO SURPLUS TO POLICYHOLDERS Outstanding Losses and Loss Expenses Reinsurance Payable on Losses and Expenses Unearned Premiums Ceded Reinsurance Premiums Payable Other Liabilities 5 7,823 012 1,421 176 2,145,775 261.275 551,641 TOTAL LIABILITIES 12,202880 Cannel Stock Paid -In Surplus Unassigned Funds 20,980 2,711,474 1,591,718 SURPLUS TO POLICYHOLDERS 4324172 TOTAL LIABfLITIES AND SURPLUS 16,527,052 investments ore valued in accordance with requirements of the National Association 01 Insurance Commissioners. At December 31 2020 investments wnh a carrying value of 507,794,700 were deposited with government authorities as required by law STATE OF PENNSYLVANIA COUNTY OF PHILADELPHIA jam Taylor, being duty sworn, says that he is Senior Vice President of Federal Insurance Company and 12151 10 the test 01 1115 knowledge ino belief the foregoing ,a a true and correct statement of the SSA Company's financial conic:Man as of the 31 at clay of December 2020 —1, - ykx,e5taggi iNfore me this 1 1 iLrktr'± ?), Ncdwy Public ISSKT1 eAp.fli5 Commonwealth of Pennsylvania - Notary SuaI Diane Wright, Notary Public, Philadelphia County My commission explresAugust 8, 2023 Commission number 123514f krumber. Pennsylvania Association of Notaries SECTION V — Contract Documents CONTRACT (1) ..2ret This CONTRACT made and entered into this9 day of , 2(0)1 by and between the City of Clearwater, Florida, a municipal corporation, hereinafter designated as the "City", and Poole & Kent Company of Florida, of the City of Tampa, County of Hillsborough and State of Florida, hereinafter designated as the "Contractoe. [Or, if out ofstate:} N/A This CONTRACT made and entered into this day of Florida a municipal corporation, hereinafter designated as a/an uelaware (State) Corporation authorized to Tampa County of Hillsborough the "Contractor". WITNESSETH: , 20 by and between the City of Clearwater. the "City", and Pte & Kent Company of Flonda do business in the State of Florida, of the City of and State of Florida , hereinafter designated as That the parties to this contract each in consideration of the undertakings, promises and agreements on the part of the other herein contained, do hereby undertake, promise and agree as follows: The Contractor, and his or its successors, assigns, executors or administrators, in consideration of the sums of money as herein after set forth to be paid by the City and to the Contractor, shall and will at their own cost and expense perform all labor, furnish all materials, tools and equipment for the following: PROJECT NAME: North East WRF Improvements PROJECT NO.: 19 -0029 -UT in the amount of $18,437,514.70 In accordance with such proposal and technical supplemental specifications and such other special provisions and drawings, if any, which will be submitted by the City, together with any advertisement, instructions to bidders, general conditions, technical specifications, proposal and bond, which may be hereto attached, and any drawings if any, which may be herein referred to, are hereby made a part of this contract, and all of said work to be performed and completed by the contractor and its successors and assigns shall be fully completed in a good and workmanlike manner to the satisfaction of the City. If the Contractor should fail to comply with any of the terms, conditions, provisions or stipulations as contained herein within the time specified for completion of the work to be performed by the Contractor, then the City, may at its option, avail itself of any or all remedies provided on its behalf and shall have the right to proceed to complete such work as Contractor is obligated to perform in accordance with the provisions as contained herein. SECTION V Page 3 of 17 Updated: 5/4/2020 SECTION V—Contract Documents CONTRACT (2) THE CONTRACTOR AND HIS OR ITS SUCCESSORS AND ASSIGNS DOES HEREBY AGREE TO ASSUME THE DEFENSE OF ANY LEGAL ACTION WHICH MAY BE BROUGHT AGAINST THE CITY AS A RESULT OF THE CONTRACTOR'S ACTIVITIES ARISING OUT OF THIS CONTRACT AND FURTHERMORE, IN CONSIDERATION OF THE TERMS, STIPULATIONS AND CONDITIONS AS CONTAINED HEREIN, AGREES TO HOLD THE CITY FREE AND.HARMLESS FROM ANY AND ALL CLAIMS FOR DAMAGES, COSTS OF SUITS, JUDGMENTS OR DECREES RESULTING FROM ANY CLAIMS MADE UNDER THIS CONTRACT AGAINST THE CITY OR THE CONTRACTOR OR THE CONTRACTOR'S SUB CONTRACTORS, AGENTS, SERVANTS OR EMPLOYEES RESULTING FROM ACTIVITIES BY THE AFOREMENTIONED CONTRACTOR, SUB CONTRACTOR, AGENT SERVANTS OR EMPLOYEES, TO THE LIMITS OF § 725.06(2). In addition to the foregoing provisions, the Contractor agrees to conform to the following requirements: In connection with the performance of work under this contract, the Contractor agrees not to discriminate against any employee or applicant for employment because of race, sex, religion, color, or national origin. The aforesaid provision shall include, butnot be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; lay off or termination; rates of pay or other forms of compensation; and selection for training, including, apprenticeship. The Contractor agrees to post hereafter in conspicuous places, available for employees or applicants for employment, notices to be provided by the contracting officer setting forth the provisions of the non-discrimination clause. The Contractor further agrees to insert the foregoing provisions in all contracts hereunder, including contracts or agreements with labor unions and/or worker's representatives, except sub -contractors for standard commercial supplies or raw materials. It is mutually agreed between the parties hereto that time is of the essence of this contract, and in the event that the work to be performed by the Contractor is not completed within the time stipulated herein, it is then further agreed that the City may deduct from such sums or compensation as may be due to the Contractor the sum of $1,000.00 per day for each day that the work to be performed by the Contractor remains incomplete beyond the time limit specified herein, which sum of $1,000.00 per day shall only and solely represent damages which the City has sustained by reason of the failure of the Contractor to complete the work within the time stipulated, it being further agreed that this sum is not to be construed as a penalty but is only to be construed as liquidated damages for failure of the Contractor to complete and perform all work within the time period as specified in this contract. It is further mutually agreed between the City and the Contractor that if, any time after the execution of this contract and the public construction bond which is attached hereto for the faithful performance of the terms and conditions as contained herein by the Contractor, that the City shall at any time deem the surety or sureties upon such public construction bond to be unsatisfactory or if, for any reason, the said bond ceases to be adequate in amount to cover the performance of the work the Contractor shall, at his or its own expense, within ten (10) days after receipt of written notice from the City to do so, furnish an additional bond or bonds in such term and amounts and with such surety or sureties as shall be satisfactory to the City. If such an event occurs, no further payment shall be made to the Contractor under the terms and provisions of this contract until such new or additional security bond guaranteeing the faithful performance of the work under the terms hereof shall be completed and furnished to the City in a form satisfactory to it. SECTION V Page 4 of 17 Updated: 5/4/2020 1 SECTION V — Contract Documents CONTRACT (3) In addition to all other contract requirements as provided by law, the contractor executing this agreement agrees to comply with public records law. IF THE CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF CHAPTER 119, FLORIDA STATUTES, THE CONTRACTORS DUTY TO PROVIDE PUBLIC RECORDS RELATING TO THIS CONTRACT. CONTACT THE CUSTODIAN OF PUBLIC RECORDS AT 727-562-4092, Rosemarie.Callr8tnyclearwater.com, 600 Cleveland St. Clearwater, FL 33756 The contractor's agreement to comply with public records law applies specifically to: a) Keep and maintain public records required by the City of Clearwater (hereinafter "public agency") to perform the service being provided by the contractor hereunder. b) Upon request from the public agency's custodian of public records, provide the public agency with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost provided for in Chapter 119, Florida Statutes. as may be amended from time to time, or as otherwise provided by law. c) Ensure that the public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law for the duration of the contract term and following completion of the contract if the contractor does not transfer the records to the public agency. d) Upon completion of the contract. transfer, at no cost, to the public agency all public records in possession of the contractor or keep and maintain public records required by the public agency to perform the service. If the contractor transfers all public records to the public agency upon completion of the contract, the contractor shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the contractor keeps and maintains public records upon completion of the contract, the contractor shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to the public agency, upon request from the public agency's custodian of public records, in a format that is compatible with the information technology systems of the public agency. e) A request to inspect or copy public records relating to a public agency's contract for services must be made direct' to the public agency. If the public agency does not possess the requested records, the public agency shall immediately notify the contractor of the request and the contractor must provide the records to the public agency or allow the records to be inspected or copied within a reasonable time. f) The contractor hereby acknowledges and agrees that if the contractor does not comply with the public agency's request for records, the public agency shall enforce the contract provisions in accordance with the contract. g) A contractor who fails to provide the public records to the public agency within a reasonable time may be subject to penalties under Section 119.10, Florida Statutes. h) If a civil action is filed against a contractor to compel production of public records relating to a public agency's contract for services, the court shall assess and award against the contractor the reasonable costs of enforcement, including reasonable attorney fees, if: 1. The court determines that the contractor unlawfully refused to comply with the public records request within a reasonable time: and CONTRACT (4) 2. At least 8 business days before filing tate action, the plaintiff provided written notice of the public records request, including a statement that the contractor has not complied with the request, to the public agency and to the contractor. i) A notice complies with subparagraph (h)2. if it is sent to the public agency's custodian of public records and to the contractor at the contractor's address listed on its contract with the public agency or to the contractor's SECTION V Page 5 of 17 Updated 5/4/2020 SECTION V — Contract Documents registered agent. Such notices must be sent by common carrier delivery service or by registered, Global Express Guaranteed. or certified mail, with postale or shipping paid by the sender and with evidence of delivery, which mav be in an electronic format. A contractor who complies with a public records request within 8 business days after the notice is sent is not liable for the reasonable costs of enforcement. IN WITNESS WHEREOF, the parties to the agreement have hereunto set their hands and seals and have executed this Agreement, the day and year first above written. CITY OF CLEARWATER IN PINELLAS COUNTY, FLORIDA By: 1,0aQuiAu B. h1 It William B. Horne, II City Manager Countersigned: Auest: bd-Untftic., Rosemarie Call ity Clerk •,-41-412 By: Frank Hibbard Mayor Approved asto orm: Owen Kohler Assistant City Attorney Contractor must indicate whether: x Corporation, Partnership, Company, or Individual Poole & Kent Company of Florida (Co 13y: (SEAL) Print Name: filotichz.. (Am_ Title: .Le -11 6..=0 The person signing shall, in his own handwriting, sign the Principal's name, his own name, and his title; where the person is signing for a Corporation, he must, by Affidavit, show his authority to bind the Corporation - provide Affidavit. SECTION V Page 6 of 17 Updated: 5/4/2020 SECTION V — Contract Documents CONSENT OF SURETY TO FINAL PAYMENT TO OWNER: City of Clearwater PROJECT NAME: North East WRF Improvements Engineering PROJECT NO.: 19 -0029 -UT 100 S. Myrtle Ave. CONTRACT DATE: [ ] Clearwater, FL 33756 BOND NO.: [ ], recorded in O.R. Book 1 ], Page [ ], of the Public Records of Pinellas County, Florida. CONTRACTOR: Poole & Kent Company of Florida Pursuant to § 255.05(11), Florida Statutes, and in accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the: [insert name of Surety] [address] [address] on bond of Poole & Kent Company of Florida 1715 W. Lemon Street Tampa, FL 33606 ,SURETY, ,CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve Surety of any of its obligations to City of Clearwater Engineering 100 S. Myrtle Ave. Clearwater, FL 33756 as set forth in said Surety's bond. IN WITNESS WHEREOF, the Surety has hereunto set its hand this day of Attest: (Seal): SECTION V ,OWNER, (Surety) (Signature of authorized representative) (Printed name and title) Page 7 of 17 Updated: 5/4/2020 ‘1.11311) BOND Filled out II !, JIM. IS stIbM1110.11 KNOW. \ ALL %WS 11\ Ill ESI- PRFSI- N1 S: I lial ,.%., the tiriderc.itAi.:d. Poole & Kent Company of Florida 1715 W, Lemon Street. Tampa, FL 33606 t. iract fintk ,f ad nTravelers Casualty arid Surety Company of America ___............. .1, 'sok:I, %%hos,: ,sddress is One Tower Square, Hartford, CT 06183 are held and limit% t Rind rano the Cu\ of Ile,um mei Florida. in the sum of Ten Percent of the Amount Bid Dollars tSi 10% of Arot. Bid i i beiiiil a minimum of I0Po of Contractor's total bid amount i kir Ilipal.inent of ‘N Inch. %%cll and trul% to he made %%,.• her....b% lointl% and socrall% bind oursel%es, our heirs, inecuiors. administrators successors and assigns The condition of the atxn.e obligation is such firm it ih attached Proposal of Poole & Kent Compaq of Florida as Conuactor and Travelers Casualty and Surety Company of America as Suri ‘ for %sort, specified Noah East WRF Improvements. Project No 19 -0029 -UT all as stipulated in said Proposalb% doing all %sork incidental thereto. in accordance vk MI the plans and specifications pro % idcd hcreforall ithin Pinellas Count . is accepted and the contract rmarded to the abow named bidder. and the said budder shall within ten das after notice or said am, ard cntcr into a contract, in wnting. and furnish thc required Public Congruction Bond with suretyor sureties to be approi ed b the Ciq Manager. this obligation shall k old. other Ise the same shall be in full force and Mite bs ink and the full amount of this Proposal/Bid Bond %%ill hc paid to the Cit. as stipulated or liquidated damages. as Principal must indicate %%hethcr X Corporation Partnership ( *Impartor Indn dual StgIk.d this 4th da) of February .20 21 Poolv & Kent ( ompam of Honda Conti at: tor Pallid, 11 ( air Primi I Travelers Casualty and Surety Coniparly of America Suret% Camille Maitland, Attorney -In -Fact Non Resident License MO12268 The person signing shall. in his on hand%%nting. sign the Principal's name, his own name. and his title; is signing, for a Corporation he must. b% Nflida‘n. sho%% his audit qii% to hind the Corporation - proifideAfri HON V $ ' Updated 5/4i/020 TRAVELERS Travelers Casualty and Surety Company of America Travelers Casualty and Surety Company St. Paul Fire and Marine Insurance Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS That Travelers Casuaity ax l Surety Cceipare cif America, Travelers Casualty and Surety Compare/ and St Paul Fire and Marine Insurance Craripany are corporations (fury organized under me laws of the State of Connecticut (he(ein collectrvery cased the 'Cr:meanies-) and that the Companies do hereby make constitute and appoint Gamine Maitland of UnIondaki New York, their true and lawful Attorney in Feu to syn, execute seal and acknoweidge aey and air bores recograzances, conabonal uncertakings and other writings obligatory in the nature thereof on behalf of the GOrripaniell in their business guar-acids...mg the reetrty of persons, 4uaranteeing the perromance of contracts and executing or guaranteeing bonds anti undertakings requee0 or peen/Jeri vs any &a)orts or vac:ea:sings allowed by taw IN WITNESS WHEREOF the Companies have canned anis instrument In be signed, and their corporate seals 10 De hereto affixed Mrs 30i day of February 2017 State or Cennectice City or ilarreei ss On leis the 3rd lay of February 2017 before me personary appeared Robert L Raney. %veto acknowledged himself to be the Serie: Vice President of Travelers Casualty ad Surety Company of America Travelers Casualty and Surety Company, end St Paul Fire and Marine Insurance Company, and Mat ne as such being authorized so to do executed the foregoing instrument for the purposes therein contained by signing on behalf of the coma ations by himself as a duly authorized cfficer In Witness Whereof hereunto set my hand are official seal My Commission expees the 30th day of June 2021 %ALA- C, taktauJi Mane C reeeault Matey Public This Power of Attorney ts cav anted under and by the authority of the foilowing resolutions adopted by the Boards of [Seeders of Travelers Casualty and Surety Company of Amenca, Travelers Casualty and Surety Company, and St Paul Fire and Marine Insurance Company which resolutions are now in fuI force and effect reading as follows RESOLVED. that the Chairman, the President any Vice Chairman. arty Executive Vice President any Senior Vice President any Vice President, any Second Vice President the TreaSurer, any Assistant Treasurer. the Corporate Secretary ix any Assatare Secretary may impotent Attorneysen-F act and Agents to act for and on behalf of the Company and may give such appointee slice authordy as his or her certificate of authority may prescribe to sign with the Compaq% name and seal with the Company's seal bonds, recognizances. contracts of indemnity and other writings Obligatory In the nature of a bond, recognizance or conditional undertaking and any of said officers or the Board of Directors al any erne may remove any such appointee and revoke the power given him or her aric 4 FURTHER RESOLVED, triat the Chairman the President any Vice Chairman any Executive Vice President any Senior Vice Feeseent or any Vice President may delegate all or any part of the foregoing authortly to one or more officers or employees of iris Company provided that each such delegation is in writing and a copy thereof 6 filed in the office of the Secretary; and 4 is FURTHER RESOLVED. Mat any bond, recognizance contract of indemnity, or vexing obligatory in the nature GI a bond recogeoance or conditional undertaking chart be valid and binding upon tne Company when (5) signed by the President any Vice Charman, any Executive Vice President any Senior Vice Resident or any Voce President, any Second Vice Resident. the Treasurer any Assistant Treasurer. the Corporate Secretary or any Assistant Secretary and duly attested and seaied with the Company's seal by a Secretary essrstant Secretary or (ix) duty executed ,under sear rf requrrea) by one or more Attorneys eeFact and Agents pursuant to the power prescribed in his or her certificate or thee certificates of authority or by one or more Company officers pursuant to a written delegation of authonty. and it is FURTHER RESOLVED that the signature of eacn of the following officers President any Executive Vice President any Senior Vice President any Vice President arty Assistant Vice President any Secretary any Assistant Secretary, and the seal of the Company may be affixed by facsimile to any Power of Attorney or to any certificate relating thereto appointing Resident We Preseseres, Reselent Assistant Secretanes or Attorneys or Foci for purposes only of executing end attesting bonds and undertakings and other wrings obligatory in Lhe nature thereof and any such Power of Attorney or certificate beanng such facsimile sgnature or facturnole seal snal be valet arid DthClog upon the Company and any such poser so executed and certified by such facsimile signature and facsimile seal shall be valid and bride.; on the Company in be Pule with respect to any bond or understanding to which s is attached I Kevin E. Hughes. the undersigned, Assistant Secretary of Travelers Casualty and Surety Company of America. Travelers Casualty are Surety Company. and Si Paul Fee and Marine Insurance Company do hereby certify that the above and foregoing is a true and mired riVy Of the Power Of Attorney executed by said Companies, vvhich remains ink44 force and effect Dated ins 4th day of February 2021 E Hughes As tare Secretary To verify the authentkity o4' this Power of Attorney, please call us at 1-800-421-388a Please refer to the above-named Attorney -in -Fact and the details of the bond to which the power is attached. Florida 4 In lb, 3 February 1'1 Miami -Dade 't AR I h f 1 •thIS.1 I ITT. III \ I Patrick H. Carr plaN,1(1311\ krtinkri tyl ; vm„ s, ,0 '.= =1,1., ° hiti41 ^ to Om 10.54-940011 uJ itakn. 1,t4.45,A mc I11,P Ooo..614:4.11.11,' nc. 11.g, i tp.t,,1% arkl ,1 a,jv q t ,,fiiMe,.1,1 C ; 14:4-,ntl Upon E4.913.11 h.h aw 11,d alLit ted uted t c NEW YORE L. mile-, NASSAL, CF0051104 ALEFFOE2 Notary Public - kat* e( Florida CortrantistOrt ftli 011136 Comm Eapirea0C1 II, 2024 t Ow. 4th .1,0 441 FebruarY en the see 2,, 21 licre.ic iht timicr+IFICd, Frtstrialk pric...rtNI Camille Maitland and u he. being floc Jul4ul iJ deptKe 3.t1J Ili% 1 hat he she tsrstdesm Kings County, New 'fork that he f. Anorne% -rn-f owl ,v1 TRArFLUIRS ( %SI 11.11 •AND St -Rt.]. I (1‘111 \ I (W Atli RR 1, the Leirporatteal deumbcd arKt %shut, c‘ccuted the a alum inetriantan that hc 41,e knous thc onrporate ;cal ot Laid eernrrin L that thc u. tlt sed Ito said inatrumait uich Lorinitritc seal arid then he shs- signed said instrument as Morrie% -en-f act hs aulleeints ut thy Ituard tit ihrcLarie. rn pan% . and alliant did wither depene. and s haithe stericiuntradcret eit the: Statc ert Nest tkparanent i finanual Seri te.c, hiot pursuant I 1 1 irt the Neu Vinli In‘aranse t 31A 1.4.4104 15, I RAVII14RS ( %SI %11, 11 \I) Si 41 1) ( ()NW \ 1 OF ‘5,11,141( ht het I it. .hi Sa1,1 .Itnpwr ieiairtied les be....tire,, and he sc.:erred a. arrems e'er trimmers on all bonds undertakings, recelernizanees guarantees slid '4'11?:.Zitt 41, • t1.3441110,1 recnnitited hiL 1ave and Lbw uh0:4414.4W h4, two rc,,,„4„,,,L personalh kneinn bI itAFITFORP EnNilF7talf CE43 PletaNDAL STATEMENT AS OF DECE0413FF1 Al Flirt) 04 THE SFATE rriiM,. !!Art+4 S.'iat'10C Nolan Pub NELLY RENCHIWICH Notary Public, State of New York No. 01RE6218158 Qualified in Nassau County Commission Expires March 1, 2022 e5SE 15 L,434144.-5. ... AND Wit MOS FOE145 HAS l'FJEF41. 1/COME EVE .0.17; "st.,..FtE 01 1ER :FIVE SITU ASSETS PRE1111.114 BALANCES ME t DCFEFIRED1M A'Ir RENSLIFIANCEFIECOVERABLE SEE LJR111E5 LINE:TNT, c'IETIVE `.7 ' E Cat kAF.EPAL A351E RIU'VABLE5 (PQM PaPE US ID LAP IE1 ANC AFT1L4AT•4 ASSLAIED FLN "P.4.44C F 1,411,1•AND eArae,j 7.1',1EP A5SETt ":37 933 444 1;230 412 39E6514 263 4 263 52,134 92b 31.,X3.523 3732 *V 55F 936 3 'IC< 44.61mENI E.TEP45E 5 i :40445 ...'I 1, 4.5E S ANC/ 4EE'r. REAINSES "ArtiFtErit FEDERAL Anka TOTIEGTO tT,JCOmt TAXES REMIT 74MCESAND ITEMS NOT ALLOCATED 4,40 INT ; WITHHELD ,REINUELI CIIWPANY FOR DT ..r4E RE1KURANCEPEALPV4 Miat'n-e0L1".•Efl ()WENDS 4CR RENE VANCE :afiCE 49E 040444 'ELL ;OR g_CUPitES LEhOsteCe tr,tr, 9E9531104CE NET DREatrows werkoLE JIHLmA.LCRULL1 EXPLINSL'a AND uA2tulttE5 'Clesi:LA7311.01E, F, 5.4t St.94PLUS ".niER,SUPPtlIS 1L RUS.19 P*9=-"C354CILt ,A.F 11lr Pt_ • n5,557 2O47.57..i ill nae% lte" 3E71457 •4 F20.980 43 1 34.64B 12 674 157 196474 ?55EFS.276 126.25t '1 02W 9,33T 14000 3 7325M fri9811 447917 1 220.3T:4% 14 :Or SECTiON - Contract Deccoienis AFFIDAVIT op be tilled in And e‘ectited it the bidder k corporation) STATE OF FLORIDA COUNTY OF Miarni-Dade David A. Strickland , being duly sworn. deposes and says that he,she is Secretary of Poole & Kent Company of Florida a corporation organized and existing under and by virtue of the laws of the State or Florida, and having it, principal office at: 1781 NW North River Drive Miami Miami -Dade FL (Street & Number) (City) (County') (State) Affiant further says that he is familiar with the records. minute books and by-laws of Poole & Kent Company of Florida (Name of Corporation) Affiant further says that Patrick H. Carr (Officer's Name) (Title) is President & CEO of the corporation. is duly authorized to sign the Proposal for City of Clearwater Or said corporation by virtue of attached resolution dated February 3, 2021 (slaw iiiliMXXXXXXXASXXXXXXXIO(XXXYXXXXXX or a Resolution of Board of Directors If by Resolution of -an David A. Stric and, Assistant Secretary A I fiant Sworn to before me this 3rd day of March . 10 21 oik• CHRISTrNE mEro0E2 Notary Public 5utt of Florlog CommIssiono 1H 0111136 c.rs- my Comm. Expires Oct 3, 202+ goncet through riatiora hoa-r ASV' SECTION V Notary Public Christine Mendez Type print stamp name of Notary Notary Public, State of FL #HH 018836 Iiik or rank. and Serial No.. if any Page 9 of 17 Updated: 5/4/2020 SE 3"_!* AFFIDAVIT (To he tilled in and e if the bidder is a corporation) STATE OF FLORIDA Miami -Dade COUNTY OF David A. Strickland , being duly sworn, deposes and says that he/she is Secretary ot' Poole & Kent Company of Florida a corporation organized and existing under and by virtue of the Im%s of the State of Florida. and having its principal office at: 1781 NW North River Drive (Street & Number) Miami Miami -Dade FL (City ) (County (State) Aftiant further says that he is familiar ith the records, minute books and by-laws of Poole & Kent Company of Florida (Name of Corporation) Affiant further says that Brian D. MacClugage (Officer's Name) 1 ilk) of the corporation. is duly authorized to sign the Proposal for City of Clearwater is Executive Vice President or said corporation by virtue of (state whether a provision or by Resolution of Hoard of Directors, If by Resolution giv attached resolution dated February 3, 2021 Sworn to before me this 3rd day of SECTION V ...0.A, r. CHRISTINE mEN:EZ .. i 4-1,- . %ctar, Publk , State 3' r once :: Z CommIssion $ M4 35836 ki, r. orrw , i. Expires Oct 3erceo throcch Natiena. Notary assr ill -"to.. avid A. Strickland, A fliant March ssistant Secretary ublic Christine Mendez Type print stamp name of Notary Notary Public, State of FL #HH 018836 Title or rank. and Serial No.. if any Page 9 of 17 Updated. 5/4/2070 o &id , kited it the bidder A orporatiort S 1 1, FE OF FLORIDA Miami -Dade COUNTY OF David A. Strickland . being duly ;worn. deposes and :ay; that he ;he is Secretary of Poole & Kent Company of Florida a corporation organized and existing under and by inue of the laws of the State ot Florida, and liming its principal office at: 1781 NW North River Drive Miami Miami Dade FL (Street & Number) (City) (('ounty ) (Stare) Aftiant litniler says that he is familiar with the records, minute books and by -laws of Poole & Kent Company of Florida s\.Inve of Corporation) ffiant further says that David B. BuShea ((I -leer's Name) (Title) is Vice President of the corporation. is duly authorized to sign the Proposal for City of Clearwater Said corporation by virtue of Soni to before me this SECTION 3rd attached resolution dated February 3, 2021 (state whether a provision of by laws or a Resolution of Board of Directors If by Resolution gi 'adoption a ot CHAIST.thE KEN:El Notary Put K State of E,ortca Ccerimission i Het C*8836 '1.o. es hi) Comm, Eiptrips Oct l' 202e B,oeded through Native, Pt 1:4 ary ASV David A. Strickland. Assistant Secretary A Itiant March , 10 21 Now) Public Christine Mendez . 1) pe print stamp name ot Notary Notary Public, State of FL #HH 018836 Title or rank. and Serial No.. if any Page 9 of 11 Updated 5/4/2020 sTATE OF FLORIDA COUNTY OF Miami Dade Patrick h. Carr NON -COLI .1 'SION AFFIDAVIT being. first duh swOrn. deposes and says that he is President & CEO of Poole & Kent Company of Florida the party making the foregoing Proposal or Rid: that such Bid is genuine and not collusive or sham: that said bidder is not financially interested in or otherwise affiliated in a business w a) with an other bidder on the same contract; that said bidder has not colluded. conspired. connivedor agreeddirect!) or indirectl) • ith an bidders or personto put in a sham bid or that such other person shall refrain front biddingand has not in an, manner, directly or indirectly, sought by agreement or collusion, or communication or conference. with am person, to ft% the bid price or affiant or any other bidder. or to tix any overhead. profit or cosi element of said bid price. or that of .w other bidder, or to secure any advantage against the City of Clearwater. Florida. or an person or persons interested in the proposed contract: and that all statements contained in said proposal or bid are true; and further. that such bidder has not directl) or indirectly submitted this bid. or the contents thereof, or divulged information or data relative thereto to any asau tor to anjnember or agent thereof Sworn to and subscribed before me this SECTION V 3rd da) of Aftiant Patrick H. Carr. President & CEO March -,(1 21 - Norm) Public Christine Me .., CAISTNE mENCEI houry State of Fiondi V,S;kitta Cornemstoe I PM 011116 ray Comm, how's Oct I' 2024 Bolded through Platuvia, hour, ikstr Page 10 of 11 Updated: 5/4/2020 SECTION V— Contract Documents PROPOSAL (1) TO THE CITY OF CLEARWATER, FLORIDA, for North East WRF Improvement (19 -0029 -UT #) and doing such other work incidental thereto, all in accordance with the contract documents, marked North East WRF Improvement (19 -0929 -UT #) Every bidder must take notice of the fact that even though his proposal be accepted and the documents signed by the bidder to whom an award is made and by those officials authorized to do so on behalf of the City of Clearwater, Florida, that no such award or signing shall be considered a binding contract without a certificate from the Finance Director that funds are available to cover the cost of the work to be done, or without the approval of the City Attorney as to the form and legality of the contract and all the pertinent documents relating thereto having been approved by said City Attorney; and such bidder is hereby charged with this notice. The signer of the Proposal, as bidder, also declares that the only person, persons, company or parties interested in this Proposal, are named in this Proposal, that he has carefully examined the Advertisement, Instructions to Bidders, Contract Specifications, Plans, Supplemental Specifications, General Conditions, Special Provisions, and Public Construction Bond, that he or his representative has made such investigation as is necessary to determine the character and extent of the work and he proposes and agrees that if the Proposal be accepted, he will contract with the City of Clearwater, Florida, in the form of contract; hereto annexed, to provide the necessary labor, materials, machinery, equipment, tools or apparatus, do all the work required to complete the contract within the time mentioned in the General Conditions and according to the requirements of the City of Clearwater, Florida, as herein and hereinafter set forth, and furnish the required surety bonds for the following prices to wit: lithe foregoing Proposal shall be accepted by the City of Clearwater, Florida, and the undersigned shall fail to execute a satisfactory contract as stated in the Advertisement herein attached, then the City may, at its option determine that the undersigned has abandoned the contract, and thereupon this Proposal shall be null and void, and the certified check or bond accompanying this Proposal, shall be forfeited to become the property of the City of Clearwater, Florida, and the full amount of said check shall be retained by the City, or if the Proposal Bond be given, the full amount of such bond shall be paid to the City as stipulated or liquidated damages; otherwise, the bond or certified check accompanying this Proposal, or the amount of said check, shall be returned to the undersigned as specified herein. SECTION V Page 11 of 17 Updated: 5/4/2020 Attached hereto I'ROJ)4 \L a bond or certified check gni Bid Bond Rank, for the sum of ten percent (10'61 of total bid amount of 1 a°o of Contractor's total bid amount i ing :r minimum The full names and residences of all persons and parties interested in the foregoing bid are as follows: (If corporation. gise the names and addresses of the President and Secretary . If firm or partnership. the names and addresses of the members or partners. The Bidder shall list not only his name but also the name of any person with whom kidder has any type of agreement whereby such person's improvements. enrichment. employment or possible benefit. whether sub- contractor, materialntan. agent. supplier. or employer is contingent upon the award of the contract to the bidder). NAMES: see attached ADDRESSES: Signature of Bidder Patrick H. Carr, President & CEO The person signing shall. in his own handwnting, sign the Principal's name, his own name and his title %%here the person signing for a corporation is other than the President or Vice President. he must. by affida%it, show his authority, to bind the corporation. Principal: tUt C"t - CL t t - By: Title. Company Legal Name: Poole & Kent Company of Florida Doing Busine • As l if different thanaboteh Business Address of Bidder 1715 W. Lemon Street City and State: Tampa, FL Phone: 811251-2438 [mail Address; daveb@pkflorida.com Dave BuShea Dated at Tampa, FL .1116 3rd das of March A.I).. 2x21. Zip ('ode 33606 SECTION V Page 12 of 17 updated_ 5/4/2420 r• . • •-•> ( 1 1 ( Li% 11(WATER kIMENDt \I SHEET PROJECT: North East NN'RF Ininroi cnicots (19 -0029 -UT Acknowledgment is hereby made of the following addenda received since issuance of Plans and Specifications. Addendum No. I Addendum No. 2 Date: 2103/2021 Date. 2'22/2021 Addendum No. .3 Date: J ps/2c.ti Addendum No. 4 Date: Addendum No. Date: Addendum No. Date: Addendum No. Date: Addendum No. Date: Addendum No. Date: Addendum No. Date: Addendum No. Date: Poole & Kent Company of Flonda (Name of Bidder (Signature of Officer) President & CEO Patrick H. Carr (Tide of Officer) March 3, 2021 (Date) Page 13 of 17 Updated: 5/4/202L 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 BI[)t)F,R' PROPOS. (. PROJECT: North East "RF Impros ements 119 -11029 -CT s c O\TKACTUR Poole & Kent Company of Honda BIDDER'S (.It \I) TOTAL: S � f.,, �''°JLc_�_� h r 01 BIDDER'S l,RA\I) 1111 .1.1. gar Numbers., t Words ITF 1 \C). BASE BID ITEMS BASE t�"'IT EST. - QTN'. ! UNIT PRICE Rcontent, of rsi.ting sludge 'torage argil hlendtunl< t accordance 111th Section 01150. 3.01A . €`t DES( RIPTION 71 C C' . 2 NORTHEAST V4 it SLUDGE BLEND TANKS IMPROVESMENTS 1 Rcontent, of rsi.ting sludge 'torage argil hlendtunl< t accordance 111th Section 01150. 3.01A . €`t lfI(} E yY ♦ 71 C C' . 2 1 isttng sludge storage and blend tank cneretc crack repair in accordance +s ith Section 01150, 3,0113. 11- 100 j 1 Ytsting sluJgr atorage and blend tank spatted enrtcrctc repair In a.cisrJancc w ith Section 1)1151I, 3.111(% 41' 54 t t Wit` T 1)cmoiitic ri o1 c cistng aeration equipment. mixing equipment. and associated appurtenances In accordance malt Se .t tl1 1511. f xisting,rd+srontrul piping, stair treads. and tank isalk+sa} repair and refurbishment in accordan..c ith Scclicrn 0115tf, 1,011, 1 ti 1 fit s E+ C'k�arr and soat the interior ' r O1 the existing sIuJge star t and blend tanks in acdancc ss uh Se tion 01150. 3:011 1 % 1 t 7 Sludge storage and blend tank.. pump xtati ins, and yard piping equipment and rehabilitation in .i. rd;tr!ce is ith S.,•tion it t 1311„ 3.01(1 I S 1 { j z y:: ! 2 3 tints €ru,1 tai#-tG�a.iini and .ma .1- Jteeste fed pump sation .anop, itJ;use . ssfth Section u 1_ 1 1 9 f)euaterin feed pump station canopy rernrn a1 and rcplarrnsrnt in accordancess ith S .11on 01150, i 0 t I> 1 1 10 Thickened prima n sludge and thickened V AS yard piping modification in accordance m,101 Section 01150, 3,01,1 1; 1 `"c, c` -c 11 S1cihiluauem In accordance with Set. -tion 01150. 3,111 K [.S 12 fndemniticatiun in a.cordance %% ith Scstu+sn 4 1150. 3.01L 1_S 1 IiKI.Itit 9 Sub- ©tal NE WRF Sludge Blend Tanks Imp 1 Ido Ou lues Contingency 1.S 1 S 171 y t4 1 7 2 = Total NE SURF Sludge Blend Tanks Imp 1 SECTION V 14 of UpCated. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 . Contiact NF: 18 RE GRIT RENION .11„ MO\ INC BEA. r FILTER A'S D EQ1., EN1 IN1PROS EN1FN IS 14 '5:1 Vi. RI lirctrcaimcnan 3. trc.:tnicnp i d prnai i inro% cmcnt, I N accoidan,c ‘•,,11.1.`"cclion1111.7.70_ 3 ol \ . I I -ti 6 .1+, 4. 1.44', 1,Y- . 15 1(ernivi al and replacement of :he :op piirtion iit the e \ i‘tiny primar clartIkr effluent ho \ channel in acoirdance %\lth S,!,..tiiiii I S 0115(1. ; li I ( ) 1 ' , /2C0 ..-. 1ti 1<eltahilit.ition i.ii the v.iiIIN and t1I1r 1 the flo%\ channel in the hcakh%oriss huildint.... the 11‘m channel to the primar) clarifier splitter Ki‘, 'tie primar, clarifier spline( h''. the St um ho‘..(11,1 NI- the priniat- clarifier effluent bON Channel in accordance \%ith Section (11150, 3.011' 7;0o .g /4 7 17 Mohit,'au.in in accordance with Section 01150, 3.01c1 I.S 4'..4., ex'o, cer, 1 Indemnification in accordance kith Section 011,50, 3,0IR I.S S I 100.0(i Sub -total NE WRF Grit Removal, Nlosing Belt Filter and Equalization System Imp i 3 `t-9 1 19 Ill% Owner's Contingency LS 1Si, 9;14 tt. ‘r C. 5' t'. 44. Total NE WRF Grit Removal, Mc»ing Belt Flt , and Equalization Sys Imp Sub -total /C,(74/ i '3 7 1" Total Contingency 1.-G 74./i.7 TotContract e , 7 BIDDER'S GRAND TOTAL7!-- TIIE BIDDER'S GRAND TOTAL ABOVE IS HIS TOTAL BID BASEDON HIS UNIT PRICES AND LUMP SUM PRICES AND THE ESTIMATED Ql ANTITIES REQUIRED FOR EACH SECTION. THIS FIGURE IS FOR INFORMATION ONLY AT THE TIME OF OPENING BIDS. THE CITY WILL MAKE THE TABULATION FROM THE UNIT PRICES AND LUMP SUM PRICE BID. IF THERE IS AN ERROR IN THE TOTAL BY THE BIDDER, IT SHALL BE CHANGED AS ONLY THE UNIT PRICES AND LUMP SUM PRICE SHALL GOVERN. THE CONTRACTOR SHALL PROVIDE COPIES OF A CURRENT CONTRACTOR LICENSE/REGISTRATION WITH THE STATE OF FLORIDA AND PINELLAS COUNTY IN THE BID RESPONSE. SECTION Rage 15 of 17 lipdated 5/4/2020 SCRI 1 IN I ZED COMPANIES AND RI. SIN ESS OPERATIONS WITH CUBA AND SYRIA CERTIFICATION FORM PER SECTION III, ITEM 25, IF R BID IS S1,00,Boo OR WORE, THIS FORM musT BE compLETED AND SUBMITTED n ITII THE BID PRopOSA FAILI'RE T(? SI BM!T THIS rORtf 4S REQUIRED, 414 }. DEEM FOI'R S(*BM177:9L ‘O.VRESPONSII'E. The aftiant, by virtue of the signature below, certifies that: The vendor. company. individual, piincipal. siibsidiary. affiliate, or owner is aware of the requirements of section 287 135. Florida Statutes. regarding companies on the Scrutinized Companies with Activities in Sudan 1 ist. the Scrutinized Companies with Activ ities w the Iran Petroletun Energy Sector List. or engaging in business operations in Cuba and Sy ria. and 2, The vendor. company , indiv idual. principal. subsidiary . affiliate. or owner is eligible to participate in this solicitation and is not listed on either the Scrutinized Companies with Activities in Sudan I ist, the Scrutinized Companies with Activities m the Iran Petroleum Sector List. or engaged in business operations in Cuba and Syria; and 3, Business Operations means. for purposes specifically related to Cuba or Syria, engaging in commerce in any form in Cuba or Syriaincluding. but not limited toacquiringdevelopingmaintainingowning. selling. possessing. leasing or operating equipment. facilitiespersonnelproducts, servicespersonal property. real property, military equipment, or any other apparatus of business or commerce: and 4, If awarded the Contract tor Agreement)the vendor. company. indiv 'dual. principal. subsidiary. alTiliateor owner Y. ill immediately notit,. the City of Clearwater in writing. no later than five (51 calendar days after any of ns principals are placed on the Scrutinized Companies with Activities in Sudan List. the Scrutinized Companies vinth Activities in the Iran Petroleum Sector List. or engages in business tions L'uba and Syria, Authorized Signature Patrick H. Carr Printed Name President & CEO litle Poole & Kent Company of Florida Name of Entity Corporation STATE OF Fla COUNTY OF Mlarni-Dade The foregoing instrument was acknowledged before me on this 3rd day of , 20 by March 2 1 Patrick H. Carr (name of person whose signature is being notarized) as the President & CEO Ode) of Poole & Kent Company of Florida (name of corporation entity), personally kmnvn to me as described herein personall k n . or produce (type of identifications as identification. and 'ho did did not My Commission Expires: October 31, 2024 NOTARY SEAL ABOV1 SECTION V Notary Public Christine Mendez Printed Name CHRISTINE laiNDEZ Notary Pt.DIC State of ciorIda 1_11 Commissior 0 sm 011016 4 ? r. Aly Corm Eaves Oct I', 101A 8C4Idee tore P.ratiora h0(11 MY+ Page 16 o 7 Updated 5/4/2020 "IDN - CootractL. SCRUTINIZED COMPAN 11-, THAT BON ( )l'T ISRAEL LIST CERTIFICATION FORM PER SECTION III. ITEM 25. THIS FORM MUST BE COMPLETED 4.VD SI'BMITTED 111711 THE BID PROPOSAL. FAILURE TO SI'8.111T THIS FORM S REQl'IRED. MAY DEEM YOUR SUBMITT4L NONRESPOVSII'E. The affiant, by virtue of the signature below. certifies that 1. The vendor, company, individual. principal. subsidiary, affiliate, or owner is aware of the requirements of section 287.135. Florida Statutesregarding companies on the Scrutinized C'ompanies that Boycott Israel List, or engaged in a boycott of Israel; and /.. l'he vendor. companyindividual, principal. subsidiary, affiliate, or owner is eligible to participate w this solicitation and is not listed on the Scrutinized Companies that 13oycort Israel List, or engaged in a boycott of Israel: and 3. -Boycott Israel- or -boycott of Israel- means refusing to deal, terminating business activities, or taking other actions to limn commercial relations with Israel, or persons or entities doing business in Israel or in Israeli -controlled territories, in a discriminatory manner, A statement by a companythat it is participating in a boy con of Israel, or that it has initiated a boycott in response to a request for a boycott of Israel or in compliance withor in furtherance ofcalls for a boycott of Israel, may he considered as evidence that a company is participating in a boycott of Israel: and 4, It awarded the Contract for Agreement). the vendor. company, individual, principalsubsidiary, affiliate, or owner will immediately notify the City of Cleanvater in writing. no later than five (5) calendar days after any of its principals are placed on the Scrutinized Companies that Boy cu4 List, engaged in a boycott of Israel. STATE OF Honda COUNTY OF Miami -Dade Authorized Sipitature Patrick H. Carr Printed Name President & CEO Title Poole & Kent Company of Florida Name of Entity .Corporation The foregoing instrument was acknowledged before me on this 3rd day ofMarch . by Patrick 1i. c arr (name of person whose signature is being notari2ed) as the President & CEO (title) of Poole & Kent Company of Honda (name of corporationtentity), personally known to me as described herein personall ill • n , or produced a or identification) as identification. and who did did nolt c an My Commission Evires: October 31, 2024 NOTARY SEAL ABOVE SECTION V Notary Public Christine Mendez Printed Name Page 17 of 1/ CHRISTINE 4E040E2 Notary Public -State of horiela ffre Commission *Ism Otaaja *y Comm. Expors Oct II, 2014 Scnoeo throng 441Ierii Notary Assn Updated 5/4/2010 ttyPe VERIFICATION31-i11.1S AND OD'E'' I DOCUMENT AT ON �M��o���`�M����J'��KK|�����K������K�M� OF EMPLOYMENT ^ ^^=^~"°"�"="" ^ FORM PER FLORIDA STATUTE 448.095, CONTRACTORS AND SUBCONTRACTORS MUST REGISTER WTH AND USE THE E -VERIFY SYSTEM TO VERIFY THE WORK AUTHORIZATION STATUS OF ALL NEWLY HIRED EMPLOYEES. THIS FORM MUST BE COMPLETED AND SUBMIT TED WITH THE BID/PROPOSAL. FAILURE TO SUBMIT THIS FORM AS REQUIRED MAY DEEM VOUR SUBMTTAL NONRESPONSJVE The affiarit, by virtue of the signature below, certifies that� 1. The Contractor and its Subcontractors are aware of the requirements of Florida Statute 448.095. 2, The Contractor and its Subcontractors are regstered with and using the EVerify system to verify the work authorization status of newly hred empoyees. 3. The Contractor will not enter into a contract with any Subcontractor unless each party to the contract registers with and uses the E -Verify system. 4. The Subcontractor will provide the Contractor with an affidavit stating that the Subcontractor does not emptoy, contract with, or subcontract wth unauthorized atien. 5. The Contractor must maintain a copy of such affidavit. 6. The City may terminate this Contract on the good faith belief that the Contractor or its Subcontractors knowingly violated Florida Statutes 448.09(1)or448.095(2)(c). 7. If this Contract is terminated pursuant to Florida Statute 448.095(2)(c), the Contractor may not be awarded a public contract for at least 1 year after the date on which this Contract was terminated. 8. The Contractor is liable for any additional cost incurred by the City as a result of the termination of this Contract. STATE OF H:4 COUNTY OF n'311' 1)'`le Authorized Signature PatriA 11 Carr Printed Name President tkCEO Title Poole & Kent Compan) of Hot kia Name of Entity/Corporation The foregoing instrument was acknowledged before me by means of C3 physical presence or O online �� M��J| Patrick notarization on, this day of ^ ' 20 , by H. r (name of person whose signature is being notarized) as the p''siu'nt&CEu (title) of Poole &xrn|Company "tFlorida (name of ca,pora{ion/endty), personally known r produced :/A (type ofideobOcadon) as identification, and who did/did not take an oath. "cud" ' NOTARY SEAL ABOVE APPENDIX ~ Notary Public mn*nc. Mendez Printed Name hState wnonoaorrrm*tsi ���.~—~..~.^- P Updated 12/3/2020 VENDOR INFORMATION Company Legal/Corporate Name: Poole 8( Kent CompanyofFlorida Doing Business As (if different than above): Address: 1715 W. Lemon Street City: Tampa Phone: (813) 251-2438 State: EL E -Mail Address: daveb@pkilorida.com Fax: (813) 253-2515 Zip: 33606 Website: www.pkflorida.com DUNS # 831593533 Remit to Address (if different than above): Order from Address (if different from above): Address: Address: City: State: Zip: City; State: Zip: Contact for questions about this response: Name: David B. BuShea Fax: (813) 253-2515 Phone: (813) 251-2438 Day -to -Day Project Contact (if awarded): Name; David B. BuShea Phone; (813) 251-2438 Certified Small Business E -Mail Address: daveb@pkflorida.com Fax: (813) 253-2515 E -Mail Address: daveb@pkflorida.com Certifying Agency: Certified Minority, Woman or Disadvantaged Business Enterprise Certifying Agency: Provide supporting documentation for your certification, if applicable. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ACORE) CERTIFICATE OF LIABILITY INSURANCE Dan7/2021D ' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THiS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION iS WAIVED, subject to the terms and conditions of the policy, certain poifcies may require an endorsement. A statement on thls certificate does not confer rights to the certificate holder In Ileu of such endorsement(s). PRODUCER MARSH USA INC 1166 AVENUE OF THE AMERICAS NEW YORK, NY 10036 Phone: 866-966-0664 Emcor.Certrequestamarsh.am / Fax 203-229-6787 CN102796740-POOLE-TAM-20-21 CONTACT NAME: laic Ito. Exit: FAX No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC8 ENSURER A: Continental Casually Company 20443 INSUREDOOLE & KENT COMPANY OF FLORIDA 1715 LEMON ST. TAMPA, FL 33606INSURP INstIRER B: American Casualty Company of Reading, PA 20427 INSURER C : Transportation Insurance Co 20494 R D :NIA NIA INSURER E : INSURER F: CLAIMS -MADE V CERTIFICATE NUMBER: NYC -0I 1097298-01 REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDLTYPE IVSD FNSO SUW DR IJ POLICY NUMBER WVD! POLICY EFF (MMfODJYYYYI POLICY MfOO/YYT!DIP IMMIDO/YYYY) LIMITS A x COMMERCIAL GENERAL MAMMY GL6081316313 10101/2020 10101/2021 EACH OCCURRENCE $ 2.000,000 DAMAGE TO PREMISES (Ea occurrence) S 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) 6 25,000 PERSONAL &Any INJURY $ 2,000,000 GENERAL AGGREGATE $ 6,000,000 GEN'LAGGREGATE POLICY ! X OTHER: LIMIT APPLIES ECT PER: LOC PRODUCTS - COMP/OP AGG $ 14,000,000 $ A AUTOMOBILELUU3ILITY X X ANY AUTO OWNED AUTOS ONLY HIRED AUTOS ONLY - X SCHEDULED AUTOS NON -OWNED AUTOS ONLY BUA 6081316330 10/01(2020 1010112021 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Peraoddent) $ PROPERTY DAMAGE (Per sodden() $ Auto Physical Damage $ Induded UMBREU.ALIAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ 8 B C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y 1 N ANYPROP RIETO RIPARTN ENEXECUTI V E OFFICERrMEMBEREXCLUDED2 I ' l I (Mandatory In NH) If yes, describe under DESCRIPTION OFOPERATIONS be!ow N 7 A WC 6 81431266 (AOS) WC 6 81433616 (CA) WC 6 81421871 ( AZ, OR WI)10101!2020 t0T0112020 10/01/2020 10/01/2021 10/0172021 10(0111021 x PER OTH- STATUTE ER E.L EACH ACCIDENT $ 1,000,000 E.L DISEASE - EA EMPLOYEE $ 1,000,000 E.LDISEASE- POLICYLIMiT 1,000,000 $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACO RD 101, Additional Remarks Schedule, may be attached If more space Is required) RE 21702 - NE WRF IMPROVEMENTS - SOLICITATION #19 -0029 -UT ADDITIONAL INSURED UNDER ALL POLICIES (EXCEPT WORKERS COMPENSATION &EMPLOYERS LIABILITY) WHERE REQUIRED BY CONTRACT: CITY OF CLEARWATER COVERAGE PROVIDED TO THE ADDITIONAL INSUREDS IS PRIMARY & NON-CONTRIBUTORY. WAIVER OF SUBROGATION AS REQUIRED BY CONTRACT AND WHERE NOT PROHIBITED BYLAW. CONTRACTUAL LIABILITY 1S INCLUDED IN THE GENERAL LIABILITY COVERAGE FORM. ION CITY OF CLEARWATER 100 S.MYRTLEAVENUE CLEARWATER, FL 33756 i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLILY PROVISIONS. AUTHORESD REPRESENTATIVE of Marsh USA Inc. Maneshl Mukherlee-S'ixvuwo ne c -c - ACORD 25 (2016/03) 01988-2016 ACORD CORPORATION. ASI rights reserved. The ACORD name and logo are registered marks of ACORD 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ACO OR AGENCY CUSTOMER ID: CN102796740 LOC #: Norwalk ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY ***MARSH USA INC NAMED INSURED POOLE & !ENT COMPANY OF FLORIDA 1715 LEMON ST. TAMPA, FL 33606 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER' 25 FORM TITLE. Certificate of Liability Insurance AUTO PHYSICAL DAMAGE COMP 1 COLL DEDUCTIBLE $500 IN THE EVENT OF CANCELLATION OR MATERIAL CHANGE THAT REDUCES OR RESTRICTS THE INSURANCE AFFORDED BY THIS COVERAGE PART (OTHER THAN THE REDUCTION OF AGGREGATE LIMITS THROUGH PAYMENT OF CLAIMS AS APPLICABLE), INSURER AGREES TO MAIL PRIOR WRITTEN NOTICE OF CANCELLATION OR MATERIAL CHANGE TO: CERTIFICATE HOLDER SCHEDULE 1. NUMBER OF DAYS ADVANCE NOTICE FOR ANY STATUTORILY PERMITTED REASON OTHER THAN NON-PAYMENT OF PREMIUM, THE NUMBER OF DAYS REQUIRED FOR NOTICE OF CANCELLATION AS PROVIDED IN PARAGRAPH 2 OF EITHER THE CANCELLATION COMMON POLICY CONDITIONS ORAS AMENDED BY THE APPLICABLE STATE CANCELLATION ENDORSEMENT IS INCREASED TO THE LESSER OF 60 DAYS OR THE NUMBER OF DAYS REQUIRED IN A WRITTEN CONTRACT. FOR NON-PAYMENT OF PREMIUM, THE GREATER OF (1) THE NUMBER OF DAYS REQUIRED BY STATE LAW OR (2) THE NUMBER OF DAYS REQUIRED BY WRITTEN CONTRACT. 2. NAME: NOTICE WILL BE MAILED TO: CERTIFICATE HOLDER ACORD 101 (2008/01) © 2006 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD State of Florida Contractor Licenses Poole & Kent Contractors An EMCOR Company uesuunG. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 4444444 $404404 $44.14.4, c CONSTRUCTION INDUSTRY LICENSING BOARD THE GENERA, CONT RAC TOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES STRICKLAND, DAVID ALAN P004,1 & <FNE COMPANY DF FLORIDA 1781 NW NORTH RIVER DRIVE MIAMI FL 33125 LICENSEN‘4111131 808 EXPIRATION DATE: AUGUST 31, 2022 Anueo eene, k 00144 00000. 44.44Lun44t o”ut copy 00 not meet tbiS 130C.Onent #4.4 Tom Thu O you. ItolOurfLO ea anyone othet than the itctenete tot a bpr noldeem STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION nosey eleetteon itt,40•4, c CONSTRUCTION INDUSTRY LICENSING BOARD THE MECHANICAL CONTRACTOR HEREIN r. CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489 F L (AIDA STATUTES STRICKLAND, DAVID ALAN POOLE &KENT COMPANY OF F LORIDA 1 re 1 NW NORTH RIVER DRIVE MIAMI FL 33125 LICENSE NUMBER: CMC057192 EXPIRATION DATE, AUGUST 31.2022 Quays wooly Ikermet online al MtC4, Wait ens e tam Do rot atter tem document ft: bp State of Florida Contractor Licenses • Poole & Kent Contractors An EASCOR Company 0,5* -t% Girpoo,. 04,Nee illeVapan STATE OF FLORIDA dbpr DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE Poi L uTANT STORAGE SYSTEMS CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES STRICKLAND, DAVID ALAN POOLE & KENT COMPANY OF FLORiDA 1781 NW NORTH RP/ER DR N1118,8 FI 33125 UCENSE NUMBER: KC 12S6T76 EXPIRATION DATE: AUGUST 31.2022 News rarlfy Wenn item a MvParoetai Karma. con Oa flat *SS Old clOCUMent in any tOrtn rt..; is your hice,se 4 i larfareaul for anyana *Met than Int ',Cense* to use itnnt document Mowry Srt STATE OF FLORIDA dbpr DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE PLUMBING CONTRACTOR HE Pt 15 CERTIFIED UNDER THE PROVISIONS OF CHAPTER 469. FLORIDA STATUTES STRICKLAND, DAVID ALAN POOLE & KENT COMPANY Of FLORIDA 1781 NW NORTH RIVER DRIVE mlAmi FL 33125 LICENSE NiumBEFE CFC057a8,0 EXPIRATION DATE: AUGUST 31.2022 AM ay, *Ws 'memos entire 14 Meg imictalLeentse torn Do noi alto, accurnart re any tom Thn Isc t . .0,4./0 to, WOW,* C41444 itkiir the 'Kermit to useth, CIOCumert4. State of Florida Contractor Licenses Poole & Kent Contractors An EMCOR Company STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD HE ELECTRICAL CONTRACTOR HEREIN 15 CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489. FLORJDA STATUTES STRICKLAND, DAVID ALAN POOLE A KE Nr COMPAvY OF FLORIDA 1781 t•NV NORTH RiVER DR MIAMI FL 33125 LICENSE kRAWIa&RI EC13002938 EXP1RADON DATE AUGUST 31. 2022 ANVOyl MIN Incense., trgine uhrkinclatolrPer ,o1,1 Do not flr Nit clocurnen! r any form Th4 4 VCIN n Le -le -Mot tot anyone other then the hews** to use !Ns Ooconbent Opt' STATE OF FLORIDA NinOnnge". 9ennletp, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE UNDERGROUND UTILITY & EXC.AVAPON C0 HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 484 FLORIDA STATUTES STRICKLAND. DAVID ALAN 000LE KENT comPA r OF FORIDA 1781 TAN NORTH RIVER DR Ft. 33125 LICENSE NUM8ERCUC1221171 EXPIRATION DATE AUGUST 31, 2022 Alve ,e4111, 1 IC 1 MIO F nrn Da not alto dOcument e-1 env fano Thn rota tunic n miaverul Ice yone oast NIP If* twensee to u.r.e trim ow urger; opr I-CGC061808 Strickland, David Man 1781 NW North River Ante ..thaini, FL 33125 I-CMC057192 Strickland, Dal Id Alan 1781 PiW North Riter Dr Mann, Ft. 33/25 I-CFC057380 Sincklatut, David Man 1781 NW River Dine Aftann, FL 33125 PINELLAS COUNTY CONS LICENSING BOAR THIS CERTIFIES THAT Dawid Alan Strickland DB A Poole &I Kent Company Of Florida STATE CERT* 1-CGC0618011 HAS FILED HISHER LICENSE AND PROOF OF REQUIRED LIABILITY AND WORKERSCOMPENSATION INSURANCE WITH THIS BOARD IN GOOD STANDING UNTIL September 30.2021 DAVE OF ISSUANCE. 07'232020 • Please cut out license along lines PINELLAS COUNTY CONS Tin. CTiO LICENSING BOARD THIS CERTDIES THAT David Alan Striekluid UBA rook & Kent Company of Florida SI A Itt CEA I s 1,001C857192 HAS FILED HIS/HER LICENSE AND PROOF OF REQUIRED LIABILITY AND WORKERS' COMPENSATION INSURANCE WITH THIS BOARD IN GOOD STANDING UNTIL September 30, 2021 UATE OF ISSUANCE 07232020 *Please cut out license along lines PINELLAS COUNTY CONS ON UCENSING BOARD THIS CERTIFIES THAT David Alan Strickland DRA Puuk & Kent Cowpony tif Florida STATE CERT P 1-CFC057380 HAS FILED HISHER LICENSE AND PROOF Of- RIQUIRED L IA BILITY AND WORKERS* COM PEN S ATION INSURANCE WITH THIS BOARD IN GOOD STANDING UNTIL September 30, 2021 DATE OF IssuANct raysom • Please cut out license along lines I-EC13002938 PINELLAS COUNTY CONSTRUCTION LICENSING BOARD THIS CERTIFIES THAT David Min strirldand I)BA Pook & Kent Company of Florida STATE CERT 0 I-EC13002938 HAS FILED HISOHERIJCENSE AND moot- OF REQUIRED L1ABIUTY AND WORKERS' COMPENSATION INSURANCE WITH THIS BOARD IN GOOD STANDING UNTIL September 30.2021 DATE, OF ISSUANCE 07/23R010 Strickland, David Alan along lines 1781 NW Noth River Dile Miami. FL 33125 1- PCC I 256776 Strickland, Da% id Alan 1781 NW North River Dm e Miami, FL 3312.5 1-CUC1223771 Strickland.Daysd Alan 17R1 NW Nails River Drive Miami, FL 33115 PINELLAS COUNTY CONSTRL LICENSING BOARD THIS CERTIFIES THAT David Alan Stritidand DBA Poole & Kent Company or Florida STATE CERT It 1-PCC12.56776 HAS FILED H1S/1iER LICENSE AND PROOF OF REQUIRED LIABILITY AND WORKERSCOMPENSATION INSURANCE WITH THIS BOARD IN poop STANDING UNTIL September 30, 2021 DATE Of ISSUANCE 07/23/2020 'Please cut out license ng lines PINELLAS COUNTY COIJST LICENSING BOARD THIS CERTIFIES T1LAT David Man Strickland rain Pook & Kent Company of Flrodia TATECFR I it 14 111121317i HAS HUD HISMEIR 1 ICI AND PROOF OF RFL LIABILITY AND WORKERS' UOMPINSATION INSURANCE WITH THIS BOARD IN GOOD STANDING UNTIL Stole ;ober 30, 2021 DATE OF ISSUANCE 07123/3020 * Please cut out license along lines