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Appendix A - Summons Sample Form

No: ____________

SUMMONS

Date________________

The undersigned member of the Environmental Quality Commission has been informed, and upon such information, has reason to believe that you, SAMPLE ONLY, may be found in violation of the Environmental Quality Act, Chapter 24.01 ASCA. In addition to having the power to adopt, amend, and repeal rules and regulations to assure environmental quality, the Environmental Quality Commission may issue such orders as may be necessary to enforce the rules of the Commission.

The law further states that any person who violates any provision of the Act, or any rule or regulation enforced thereto, shall be subject to a fine not to exceed $500, with each day of violation constituting a separate offense.

Therefore, under the powers of the American Samoa Code Annotated and the rules adopted by the Environmental Quality Commission, you are hereby ordered to implement the changes described below within 10 days. If corrective action is not take by that time, you shall become subject to further legal action. You may request a hearing before the Environmental Quality Commission by contacting the Office of the Governor within 10 days of the date of this order. If you have further questions concerning this summons notify the Environmental Quality Commission at the Office of the Governor.

_________________________

Violator

_________________________

Signature of Issuing Authority

Place of Offense.

___________________________________________

___________________________________________

Description of Offense.

___________________________________________

___________________________________________

___________________________________________

Corrective Changes Required.

___________________________________________

___________________________________________

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