NC0026654_PC-2017-0033 Waiver of Hearing/Stipulation of Facts_20170801

STATE OF NoRTH CAROLINA
COUNTY OF AVERY
IN THE MATTER OF ASSESSMENT
OF CIVIL PENALTIES AGAINST
Town of Crossnore
Crossnore WWTP
PERMIT NO NCO026654
DEPARTMENT OF ENVIRONMENTAL QUALITY
WAIVER OF RIGHT TO AN
ADMINISTRATIVE HEARING AND
STIPULATION OF FACTS
CASE NO. PC -2017-0033
Having been assessed civil penalties totaling $1,702 36 for violation(s) as set forth in the assessment document of the
Division of Nater Resources dated, 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.
This the day of �4�- , 20A
SIGNATURE
ADDRESS
TELEPHONE
TSag -`133-63(0

JUSTIFICATION FOR REMISSION REQUEST
Case Number: PC -2017-0033
Assessed Party: Town of Crossnore
Permit No.: NC0026654
County: Avery
Amount Assessed: $1,702 36
Please use this form when requesting remission of this civil penalty You must also complete the "Request For Remission,
Waiver of Right to an Administrative Hearing, and Stipulation of Facts" form to request remission of this civil penalty.
You should attach any documents that you believe support your request and are necessary for the Director to consider in
evaluating your request for remission Please be aware that a request for remission is limited to consideration of the five
factors listed below as they may relate to the reasonableness of the amount of the civil penalty assessed. Requesting
remission is not the proper procedure for contesting whether the violation(s) occurred or the accuracy of any of the factual
statements contained in the civil penalty assessment document. Pursuant to N C.G.S. § 143B -282.1(c), remission of a civil
penalty may be granted only when one or more of the following five factors apply Please check each factor that you
believe applies to your case and provide a detailed explanation, including copies of supporting documents, as to why the
factor applies (attach additional pages as needed).
(a) one or more of the civil penalty assessment factors in N C.G S. 143B-282 1(b) were wrongfully applied to the
detriment of the petitioner (the assessment factors are listed in the civil penalty assessment document),
(b) the violator promptly abated continuing environmental damage resulting from the violation (i e, explain the
steps that you took to correct the violation and prevent future occurrences),
(c) the violation was inadvertent or a result of an accident (i e., explain why the violation was unavoidable or
something you could not prevent or prepare for),
(d) the violator had not been assessed civil penalties for any previous violations,
(e) payment of the civil penalty will prevent payment for the remaining necessary remedial actions (i e, explain
how payment of the civil penalty will prevent you from performing the activities necessary to achieve
compliance)
EXPLANATION: