NC0025453_NOV-2022-MV-0105 70203160000041096388 GC_20220829

U.S. Postal Service'
CERTIFIED MAIL° RECEIPT
Domestic Mail Only
ROY COOPER
Governor
ELIZABETH S. BISER
Secretory
RICHARD E. ROGERS, JR.
Director
Certified Mail # 7020 3160 0000 4109 6388
Return Receipt Requested
Rich Coppola, Interim Town Manager
Town of Clayton
PO Box 879
Clayton, NC 27528-0879
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Return Receipt (electronic) $ ~
❑ Certified Mail Recoiled DeliveryED $ ~�
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❑ Adu9 Signature Restricted Delivery a �~
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RICH CAPPOLA, INTERIM TOWN MGR
TOWN OF CLAYTON
PO Sox 879
CLAYTON, NC 27528
WLt: NOV & Intent to Asses of Chill Pen/NOV_2022-MV-0105; Permit
8NC0025451/sAM'S BRANCH W97JO Ns
Rec:7020316000041096388 N1:08/23/7022
PS Form 3800 A • rig 2015 PSN 753E-02.000.8047
SUBJECT: NOTICE OF VIOLATION & INTENT TO ASSESS CIVIL PENALTY
Tracking Number: NOV-2022-MV-0105
Permit No. NC0025453
Sam's Branch WRF
Johnston County
Dear Mr. Cappola:
See Reverse tor Instructions
A review of the June 2022 Discharge Monitoring Report (DMR) for the subject facility revealed the violation(s)
indicated below:
Monitoring Violation(s):
Sample
Location Parameter
Monitoring
Date Frequency Type of Violation
001 Upstream
Hardness, Total (as CaCO3) 6/30/2022 Quarterly
(0
0900)
A Notice of Violation/Intent to Issue
Statute (G.S.) 143-215.1 and the facili
not more than twenty-five thousand d
fails to act in accordance with the tern
143-215.1.
Frequency Violation
SENDER: COMPLETE THIS SECTION
• Complete items 1, 2, and 3.
• Print your name and address on the reverse
so that we can return the card to you.
• Attach this card to the back of the mailpiece,
or on the front if space permits.
COMPLETE THIS SECTION ON DELIVERY
X
❑ Agent
❑ Addressee
1. Article Addressed to:
RICH CAP POI A, INTERIM OWN MGR
TOWN OF CLAYrON
PO BOX 879
CLAYTON, NC 27528
WQ NOV & Intent to ASSES et Lieu Pen/NOV-2022.-MV 0105/Permit l
eNC0075453/SAM'S BRANCH WRF/;OHNS
Rc1::7020316000041096383 M:08/23/2022
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1111
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D. Is delivery address different {Tom Item 1? Ye
If YES, enter delivery address below: 0 No
every
AUG 19 1021
3. Service Type
❑ Adult Si nature
❑ A ignature Restricted Delivery
ified Mail&
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0 Collect on Delivery
r-' r^"^^' on Delivery Restricted Delivery
7020 3160 0000 4109 6388 Mail
Mail Restricted Delivery.
1 lover $1 00)
L I Priority me Express®
0 Registered Mail"
O Registered Mal Restrictec
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Mer se
nature Confirmation"
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PS Forrn 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt