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APPENDIX D. Affidavit of Dismissal

AR ADC 118.01.27 Appendix DArkansas Administrative CodeEffective: August 4, 2022

West's Arkansas Administrative Code
Title 118. Department of Energy and Environment
Division 01. Arkansas Pollution Control and Ecology Commission
Rule 27. Licensing of Operators of Solid Waste Management Facilities and Training and Certification Requirements for Environmental Officers
Effective: August 4, 2022
Ark. Admin. Code 118.01.27 Appendix D
Formerly cited as AR ADC 014.03.6 Appendix D
APPENDIX D. Affidavit of Dismissal
Currentness
Affidavit of Dismissal
State of Arkansas
)
)
County of ____________
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Before me, the undersigned authority, personally appeared ___________________, who, being by me duly sworn, stated as follows:
1. My name is ______________________. I am of sound mind, capable of making this affidavit, and personally acquainted with the facts herein stated.
2. I am currently licensed as an Environmental Officer by the Environmental Compliance Resource Program of the Arkansas Department of Energy and Environment, Division of Environmental Quality.
3. Pursuant to Ark. Code Ann. § 8-6-2001 et seq., on ________________, I issued a citation, specifically citation no. ______________, to _______________________________ (alleged violator) for prohibited conduct concerning the following physical address and location: ____________________________________________________________.
4. Pursuant to Ark. Code Ann. § 8-6-2016(a), I notified the alleged violator that they had until ________________ to remediate the environmental violation.
5. Upon reviewing the attached cost statement, issuing the attached inspection report of the site property, and verifying that the environmental violations have been remediated, the environmental citation is withdrawn, and any hearing concerning this matter is unnecessary.
Further Affiant Sayeth Not.
____________________________
Name
SWORN AND SUBSCRIBED before me on the ___ day of ________________ 20___.
_________________________
___________________________
My commission expires:
Notary Public, State of Arkansas

Credits

Adopted July 9, 2020. Amended Aug. 4, 2022.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 118.01.27 Appendix D, AR ADC 118.01.27 Appendix D
End of Document