Stormwater-

Facility Name: ROCKWELL COLLINS - BUILDING 186

Permit Type: No Exposure Legal Status: Private

Address: 1500 STATE ST. - BELLEVUE , IA 52031

County: JACKSON Field Office: 1 SIC: 3812 Geospatial Information: 713219(X)/4677391(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: --PERMIT TYPE-- GP #1 GP #2 GP #3 NO EXPOSURE 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