Section Env-C 604.03 - Field Citation Form(a) A field citation form shall contain the following:(1) A place for the inspector to enter the name, address, and daytime telephone number of the respondent, and, if the respondent is an entity, the name and title of an official of the respondent;(2) A place for the inspector to enter the date and time the field citation is prepared and issued;(3) Identification of the section(s) of the statute(s), rule(s), or permit(s) for which there is a scheduled field citation fine, together with a brief description of the violation(s);(4) Identification of the statutory section that authorizes the commissioner to impose a fine;(5) Identification of the statutory section(s) or rule(s) that specify the amount of the fine and the amount of the fine specified therein;(6) A place for the inspector to enter the total amount of fine(s) sought;(7) A place for the inspector to enter his or her name and business telephone number;(8) A place for the inspector to sign the field citation;(9) A place for the signature of the individual who receives the field citation on behalf of the respondent, and for the printed name of the individual if different from the name identified in (1), above;(10) The name, address, and telephone number of the division issuing the field citation;(11) A statement that, pursuant to Env-C 604.04, the respondent is required to respond to the field citation within 25 days of the date of the field citation;(12) A statement that the respondent has the right to a hearing; and(13) The name and address of the individual in the commissioner's office to whom the respondent shall respond to pay the fine or request a hearing.(b) Each field citation form shall be produced in sets of 2 or more, either by having one original and at least one copy, such as is produced using a multi-part carbonless form, or by having multiple originals, such as is produced by a portable computer and printer.N.H. Code Admin. R. Env-C 604.03
Adopted byVolume XXXV Number 18, Filed May 7, 2015 , Proposed by #10752, Effective 12/29/2014, Expires12/29/2024.