The DEQ staff also observed the incinerator operating on March 13 and March 20, 2009. On April 4, 2009 the DEQ received the permit application from the clinic and issued a final air quality permit on June 27, 2009.

Under an administrative consent order, the clinic has agreed to pay the DEQ an administrative penalty of $4,000 for failing to obtain the permit prior to operating the new incinerator. Larry Alheim, DEQ environmental enforcement specialist, said that the clinic cooperated fully with the DEQ throughout the enforcement action.