WQCS00179_DV-2023-0049_20230405

STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
COUNTY OF FRANKLIN
IN THE MATTER OF ASSESSMENT ) WAIVER OF RIGHT TO AN
OF CIVIL PENALTIES AGAINST ) ADMINISTRATIVE HEARING AND
STIPULATION OF FACTS
Franklin County Public Utilities )
Franklin County Collection System )
PERMIT NO. WQCS00179 ) CASE NO. DV-2023-0049
Having been assessed civil penalties totaling $595.72 for violation(s) as set forth in the assessment document of the Division
of Water Resources dated March 17, 2023, 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 of assessment.
5th April
This the day of , 20 23
SIGNATURE
ADDRESS
1630 US 1 Hwy
Youngsville, NC 27596
TELEPHONE
919-556-6177