Okaloosa County BOCC — October 15, 2013 — reading text

ATTACHMENT C - OKALOOSA COUNTY - SECTION 302 FACILITIES LIST 2013-2014 Eplan # Facility Name / Address Contact County Name: Dale Brazel OKALOOSA COUNTY - LOWERY WATER WELL Contact Type: Emergency Contact 4067986 LOWERY DRIVE AND COMMANCHE AVENUE Email: DBrazel@co.okaloosa.fl.us OKALOOSA FORT WALTON BEACH, FL 32547 Home Phone :850-585-7666 24-hour Phone :850-978-0020 Name: Dale Brazel OKALOOSA COUNTY - NEWCASTLE WATER WELL Contact Type: Emergency Contact 4068019 NEWCASTLE DRIVE AND ROSS ROAD Email: DBrazel@co.okaloosa.fl.us OKALOOSA FORT WALTON BEACH, FL 32547 24-hour Phone :850-978-0020 Home Phone :850-585-7666 Name: Dale Brazel OKALOOSA COUNTY - NORTH BEAL EXTENSION SITE Contact Type: Emergency Contact 4067988 1564 PERCY L COLEMAN ROAD Email: DBrazel@co.okaloosa.fl.us OKALOOSA FORT WALTON BEACH, FL 32548 Home Phone :850-585-7666 24-hour Phone :850-978-0020 Name: Dale Brazel OKALOOSA COUNTY - NORTHGATE WATER WELL Contact Type: Emergency Contact 4068006 JONQUIL AVENUE Email: DBrazel@co.okaloosa.fl.us OKALOOSA FORT WALTON BEACH, FL 32547 Home Phone :850-585-7666 24-hour Phone :850-978-0020 Name: Dale Brazel OKALOOSA COUNTY - ODDFELLOW WATER TANK Contact Type: Emergency Contact 4067994 ODDFELLOW ROAD Email: DBrazel@co.okaloosa.fl.us OKALOOSA FORT WALTON BEACH, FL 32547 Home Phone :850-585-7666 24-hour Phone :850-978-0020 Name: Dale Brazel OKALOOSA COUNTY - OKALOOSA ISLAND BOOSTER Contact Type: Emergency Contact STATION 4068000 Email: DBrazel@co.okaloosa.fl.us OKALOOSA 110 WEST AMBERJACK DRIVE Home Phone :850-585-7666 FORT WALTON BEACH, FL 32547 24-hour Phone :850-978-0020 Name: Dale Brazel OKALOOSA COUNTY - SEASHORE VILLAGE WATER WELL 3 Contact Type: Emergency Contact 4068007 PASCHAL AVENUE Email: DBrazel@co.okaloosa.fl.us OKALOOSA MARY ESTHER, FL 32569 Home Phone :850-585-7666 24-hour Phone :850-978-0020 6 Packet Pg. 192  ATTACHMENT C - OKALOOSA COUNTY - SECTION 302 FACILITIES LIST 2013-2014 Eplan # Facility Name / Address Contact County Name: Dale Brazel OKALOOSA COUNTY - SHALIMAR WATER WELL Contact Type: Emergency Contact 4068015 SEVENTH STREET Email: DBrazel@co.okaloosa.fl.us OKALOOSA SHALIMAR, FL 32579 24-hour Phone :850-978-0020 Home Phone :850-585-7666 Name: Joe Ream SOUTH WALTON UTILITY - WELL 6 Contact Type: 112(r) 24 Hour Representative 4033485 3077 OLD HIGHWAY 98 OKALOOSA Email: jrr@swuci.org DESTIN, FL 32550 112(r) 24 Hour Representative Phone :850-978-2712 Name: Joe Ream SOUTH WALTON UTILITY - WELL 7 Contact Type: 112(r) 24 Hour Representative 4033488 431 WEST REGATTA BAY BOULEVARD OKALOOSA Email: jrr@swuci.org MIRMAR BEACH, FL 32550 112(r) 24 Hour Representative Phone :850-978-2712 Name: Jerry Regans WATER WELL #1 Contact Type: Emergency Contact 4040134 299 E John Sims Pkwy Email: regans@niceville.org OKALOOSA NICEVILLE, FL 32578 Emergency Phone :850-729-4030 24-hour Phone :850-729-4064 Name: City of Niceville WATER WELL #11 Contact Type: Owner / Operator 4040143 999 WS College Blvd OKALOOSA Email: regans@niceville.org NICEVILLE, FL 32578 24-hour Phone :850-729-4064 Name: City of Niceville WATER WELL #2 Contact Type: Owner / Operator 4040135 920 S Cedar Ave OKALOOSA Email: regans@niceville.org NICEVILLE, FL 32578 24-hour Phone :850-729-4064 Name: City of Niceville WATER WELL #4 Contact Type: Owner / Operator 4040137 601 WS Hwy 85 N (Crestview Ave) OKALOOSA Email: regans@niceville.org NICEVILLE, FL 32578 24-hour Phone :850-729-4064 Name: City of Niceville WATER WELL #5 Contact Type: Owner / Operator 4040140 99-A College Blvd OKALOOSA Email: regans@niceville.org NICEVILLE, FL 32578 24-hour Phone :850-729-4064 Name: City of Niceville WATER WELL #8 Contact Type: Owner / Operator 4040138 992 WS Rocky Bayou Rd OKALOOSA Email: regans@niceville.org NICEVILLE, FL 32578 24-hour Phone :850-729-4064 7 Packet Pg. 193  Attachment D FINANCIAL INVOICE FORM FOR HAZARDOUS MATERIALS HAZARDS ANALYSIS UPDATE _________________________________________________________________ RECIPIENT: Okaloosa County AGREEMENT# 14-CP-11-01-56-01-XXX AMOUNT AMOUNT APPROVED REQUESTED BY THE BY THE RECIPIENT DIVISION 1. First Payment (45% of contract amount) $ $ (50% Hazards Analyses completed/submitted) 2. Second Payment (45% of contract amount) $ $ (50% Hazards Analyses completed/submitted) 3. Final Payment(10% of contract amount) $ $ (approval, distribution & notification) TOTAL AMOUNT $ $ (To be completed by the Division) I certify that to the best of my knowledge and belief the billed costs are in accordance with the terms of the Agreement. ______________________________________________ _________ Signature of Authorized Official/Title Date TOTAL AMOUNT TO BE PAID AS OF THIS INVOICE $ (To be completed by the Division) Packet Pg. 194  Attachment E Hazard Analysis Contract Checklist and CAMEOfm Guide Facility Information (CAMEOfm Facility Page) Facility Name {per Attachment C} ( Facility Page) Facility Physical Address (Facility Page) Latitude and Longitude in Decimal Degrees {ex. 30.197, -84.3621} (Map Data Tab on Facility Page) Facility 24-hour Emergency Phone Number (Facility Phones Tab on Facility Page) Facility Emergency Coordinator Name and Title Contact Tab on Facility Page) Transportation Route(s) {From County Line to the Facility} (Notes Tab on Facility Page) Evacuation Route(s) to exit the Vulnerable Zone (Notes Tab on Facility Page) Historical Accident Record {If none, please note} (Notes Tab on Facility Page) Facility Population {a minimum of one is required for unmanned facilities} (ID Codes Tab on facility Page) Hazard Identification (CAMEOfm Chemical in Inventory Page) (for each Extremely Hazardous Substance on site) Proper Chemical Name(s) (Chemical in Inventory Page{s}) Chemical Abstract Service (CAS) Number (Chemical in Inventory Page{s}) Physical State in Storage {ex. mixture, pure, liquid, gas} (Chemical in Inventory Page{s}, Physical State and Quantity Tab) Maximum Quantity On-site in Pounds (Chemical in Inventory Page{s}, Physical State and Quantity Tab) Amount in Largest Container or Interconnected Containers