8 CAR pt. 62, Appendix C. Uniform Environmental Citation Form

APPENDIX C UNIFORM ENVIRONMENTAL CITATION FORM ENVIRONMENTAL CITATION State of Arkansas Ticket Number __________ Court Appearance: You are directed to appear on the ____ of __________, 20___, in District Court of _____________ County, located at ___________ ______________________________ at ____________ a.m./p.m. I PROMISE TO APPEAR IN SAID COURT AT SAID TIME AND PLACE. I UNDERSTAND THE ABOVE AND THAT MY SIGNATURE IS NOT AN ADMISSION OF GUILT. THE UNDERSIGNED issuing officer, duly authorized to issue environmental violation citations, on the ____ day of __________ 20____, has identified evidence or has reason to believe the violation(s) set forth below were committed by or were found to be on the property of: NAME: _______________________________________________ DL#/ DOB _____________________________________________ ADDRESS: _____________________________________________ ______________________________________________________ PHONE: _______________________________________________ SITE LOCATION: ________________________________________ The above listed person is accused of violating provisions of the following State environmental law(s): { } violation of the Used Tire Recycling and Accountability Act, A.C.A. § 8-9-401 et seq. { } violation of 8 CAR § 40-501 et seq.; { } violation of A.C.A. § 8-6-2005 (1), illegal dumping of solid waste or illegal disposal of solid waste on public or private property. { } violation of A.C.A. § 8-6-2005 (2), the creation or participation in the creation or furtherance of an illegal dump site; { } violation of A.C.A. § 8-6-2005 (3), the illegal disposal of solid waste or illegal dumping of solid waste has resulted from a property owner’s own household activities on his or her own land that: (A) Creates a public or private nuisance; (B) Is a hazard to health; or (C) Involves the open dumping of garbage { } other violation of Chapter 6 of Title 8 of the Arkansas Code. Remediation must be completed by the ____ day of ______________, 20______. DEQ permitted facility disposal/processing receipts are required to be submitted to the issuing officer by the remediation completion date listed above. Failure to appear in court as directed is grounds for issuance of an Arrest Warrant. SIGNATURE:____________________________________________ The undersigned further states that he/she has just and reasonable grounds to believe that the accused committed the offense as stated herein either by causing or permitting the indicated violation contrary to law on said property within ____________________ County. ISSUING OFFICER: _______________________________________ License #_________ For further information regarding this notice, contact ____________________________ ____________________________ at _________________________________________