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ENFORCEMENT MAWTENANCE CODING FORM <br />*PERMI"I' NO: C - INSPECTOR QJITfALS: <br />INFRACTION NO: CV - DATE ISSUED: <br />WSPECTION DATE: INFRACTION CATEGORY: <br />INSPECTION TIME: PRIMARY TOPIC: <br />SECONDARY TOPIC: <br />TERTIARl' TOPIC: <br />VACATION OI' NOV DATE: / / <br />V1OLATION MODIFICATION 1 DATE: / / <br />VIOLATION MODIFICATION 2 DATE: / / <br />VIOLA"PION MODIFICATION 3 DATE: / / <br />A6ATEMEN'r5: #1 #2 <br />DATE DUG: <br />EXTENDED DA"I'E: r r r r <br />UJFRACTED DATE: _ _/_ -r- _ _ _r_ _i- <br />#3 <br />r r <br />--~--~-- <br />#4 <br />r i <br />- -~- -~- - <br />• <br /> <br />DOCUMENTS: <br />'Proposed Civil Penalty <br />Civil Penally Worksheet <br />Posting Notice Assessment Conference <br />Settlement Agrzement <br />Notice & Order [o Pay Fixed Penalty <br />Notice of Vucalion of NOV <br />*This Fnnn will 6c started by the DP person and pul in specialist lilc. <br />oa- Thcsc lurms will he generated and put in file for use by Senior EPS in penalty assessment. <br />**"this Fonn will he used in conjunction with the other NOV forms. <br />**This Furm is to he routed buween DP person & Specialist until the NOV is completely finished with. <br />coal6hurc\lonu>4 0,l my9.l i w <br />