Stormwater - No Exposure Certification

Facility Name: CURTIS 1000 INC.

Permit Type: No Exposure Certificate Legal Status:

Expiration Date: (no exposure) Address: 1319 18TH STREET SOUTHWEST - MASON CITY , IA 50401

County: CERRO GORDO Field Office: 2 SIC: 2759 Geospatial Information: 481638(X)/4775283(Y)

No Exposure Certification



Application Date:	MM/DD/YYYY
Previously covered under a NPDES Storm Water permit?
If yes, enter permit number:
Certification Signed?
Permit Type:
SIC:
Notes:
Eligibility Confirmed Date:	MM/DD/YYYY
Not Eligible For Storm Water Exclusion Date:	MM/DD/YYYY
Application For Storm Water Exclusion Approved Date:	MM/DD/YYYY
Expiration Date Of Exclusion:	MM/DD/YYYY