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NOV Issuance Date ~J -rJ - ~ ~ III III I IIIIIIIII III <br />sss <br />INFORMATION <br />INITIALS <br />Due Date for Operator Comments: <br />(IS Days after Operator receives NOV) <br />Notice of Proposed Civil Penalty <br />(Due to Senior EPS for Penalty Assessment I9 days after Issuance) ' <br />3 - ~`-(- ~ ~S <br />Q17-G <br />*Proposed Penalty Due: <br />(30 days from lssuance) , <br />I - rJ - ~~i <br />Proposed Penalty Amount: <br />Date Penalty Proposed: <br />Assessement Conference Request Due: <br />(Add 10 days to date Operator received Notice of Proposed <br />Penalty; If no request go to Fixed Penalty) <br />NOV Termination Date: <br />Assessment Conference Due Date: <br />(30 days from Receipt of Request) <br />Date Assessment Conference Held: <br />Settlement Amount: <br />Date Settlement Proposed: <br />Date Signed Settlement Due: <br />(10 days from Operator's receipt of settlement) <br />Settlement Signed Date: <br />Date Settlement Penalty Due: <br />(Due 30 days from Settlement Signed Date) <br />Settlement Penalty Amount Paid & Date: <br />Notice of Fixed Penalty (120 days from NOV Issuance) <br />Fixed Penalty Amount: <br />Date Notice of Fixed Penalty Sent: <br />Date of Penalty Due: <br />(30 days from Operator's receipt of notice) <br />Date Penalty Paid: <br />Paid Penalty Amount: <br />Date of Request for Formal Hearing received: <br />Escrow Date: <br />Escrow Amount: <br />Board Hearing Date: <br />Board Hearing Decision: <br />