2017-03-23_ENFORCEMENT - M1983090 ‎(2)‎

• Permit No: M1983090
• IBM Index Class Name: ENFORCEMENT
• Doc Date: 3/23/2017
• Doc Name: Consent Agenda Summary Form
• From: DRMS
• To: Bestway Concrete and Aggregate
• Email Name: ECS
• Email Name: WHE
• Email Name: AJW
• Media Type: D
• Archive: No

M 1983-090
Consent Agenda Form
March 23, 2017
Page 3 of'3
Operator's Notarized Signature: As an authorized representative of the Permittee, I hereby attest
that the Permittee concedes to the above described violation and agrees to comply with the Cease and
Desist Order, Corrective Action, and Civil Penalty proposed in this STAFF SUMMARY FORM FOR
CONSENT AGENDA ITEMS.
Signed and dated this day of , 2017.
Mark Johnson
(Authorized representative of Bestway Concrete and Aggregate)
Signature:
Title:
State of )
ss.
County of )
The foregoing instrument was acknowledged before me this day of , 2017,
by as of
Notary Public
My Commission Expires:
SIGNATURES MUST BE IN BLUE INK