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The petition shall contain the following information: (a) <br />The name, address, and telephone number of each petitioner; the <br />Department's identification number for the Agreement and the <br />county in which the subject matter or activity is located; (b) A <br />>t rl tE mE'nt cif )'low rind whe:l `:ach pet i t -, nner received notice of the <br />Agreemftnt; (c.) A satat�ement Of howerf^_': n°'.tiCio:1�°r'S substantial <br />interests are affected by the Agreerr.pnt; (d) A statement of the <br />material facts disputed by pet___cn_r, if any; (e) A statement of <br />facts which petitioner conn -ends warrant reversal or modification <br />of the Agreement; (f) A statement of which-:Llles or statutes <br />petitioner contends require reversal modif_cat.on of the <br />Aareemet: (g) P. st,3tempnt cf the rel le':. sou_ - b•, -. ler, <br />stating precisely the action petitioner wants the i;epar=rre:lt to <br />i <br />take with respect to the Agreement. <br />if a iietiticn is filed, tl� ad :i-_st_a_ive hearing pro:: is <br />is designed to formulate agency action. AccGrdingiy, the <br />Department's final action may be different from the position <br />taken by it in this Notice. Persons whose substantial interests <br />will be affected by any decision of the Department with regard to <br />"" the subject Agreement have the right to petitio to become a <br />party to the proceeding. The petition must conform to the <br />requirements specified above and be filed (received) within 21 <br />days of receipt of this notice in the office of General Counsel <br />at the above address of the Department. Failure to petition <br />within the allowed time frame constitutes a waiver of any right <br />_ _... such person `las to Teaue:st a hearing- under: Sections i20.5669 _!nd <br />fil <br />