Work Request - Template

Work Request ID:

Program Type:

Program ID:

Type:

County:

Requested By:

Due Date:

Assigned To:

Assigned Date:

Describe Request

Date	Comment	Commenter
10/8/2019	AMPI is requesting a site separation survey for its wastewater treatment facility and the land application site in accordance with, chapter 21 subsection 21.1.1.2 of the Iowa Wastewater Facilities Design Standards and Iowa Administrative code chapter 64 subsection 64.2(3). This is an existing facility with a legal description of Sec. 36, T97N, R38W Clay County IA.	THABIT HAMOUD

Describe Request:

Request Files

Attached Files

File Name	File Type	File Date

Action Date:

Status:

Report

Attached Files/Reports

Document Name	Type	File Date	Note
AMPI Sanborn Site Survey.pdf	Inspection Report (public)	10/28/2019	AMPI Land App Site Survey

File Name	File Type	File Date	Note

Comment:

Action Type	Date	Completed Date	Comment	Delete

Field Office Compliance - Work Request