NC0021644_LV-2019-0304_20191211

STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
COUNTY OF LENOIR '0�
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61
IN THE MATTER OF ASSESSMENT ) WAIVER OF RIGHT TOA4x,N d �Fc'j �o��
OF CIVIL PENALTIES AGAINST ) ADMINISTRATIVE HE ,AND , 9�0
) STIPULATION OF FACTS `a t p
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Town of La Grange ) Via;����;
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La Grange WWTP ) „ f. o o�?�,
PERMIT NO.NC0021644 ) CASE NO. LV-2019-0304
Having been assessed civil penalties totaling$1,100.00 for violation(s)as set forth in the assessment document of the
Division of Water Resources dated November 07,2019,the undersigned,desiring to seek remission of the civil penalty, does
hereby waive the right to an administrative hearing in the above-stated matter and does stipulate that the facts are as
alleged in the assessment document. The undersigned further understands that all evidence presented in support of
remission of this civil penalty must be submitted to the Director of the Division of Water Resources within thirty(30)days
of receipt of the notice of assessment. No new evidence in support of a remission request will be allowed after(30)days
from the receipt of the notice pf assessment.
This the ! P day of / 81- , 20 /f
jSIG URE
ADDRESS
RECEIVED a1' Zit �,
DEC 171019 D "
NCDEQ/DWR/NPDES ..s /-
TELEPHONE
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