Assistance - Template

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Assistance ID:

Staff Assisting:

Program Type:

Contact:

Action Date:

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
12/15/2016	John sent a construction certification-for confinements upon completion form for the gilt developer building signed by the Mike Deahr owner of facility. This document was also sent to Paul Pettitti (DNR Engineer) Paper copy in file.	JEFFREY THOMANN

Assistance Details:

Field Office Compliance - Assistance