Work Request - Template

Work Request ID - 1204

Peters Mitchell - 310669002

1286 MARSH AVE. Little Rock, IA 51243

Lyon County

FO 3

Site Name:

Address:

City:

County:

State:

Zip:

Directions:

Section:

Tier:

Range:

Long:

Lat:

Work Request ID:

Program Type:

Program ID:

Type:

County:

Requested By:

Due Date:

Assigned To:

Assigned Date:

Describe Request

Date	Comment	Commenter
6/16/2011	Conduct Site survey and review MMP for finisher expansion. Matrix site.	PAUL PETITTI

Describe Request:

Request Files

Attached Files

File Name	File Type	File Date

Work Request Resolution

Action Date:

Status:

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
7/13/2011	Mr. Peters needs to obtain a separation distance waiver from his parents residence which is approximately 1710 ft from the proposed expansion.	DON CUNNINGHAM

Comment:

Compliance Tracking

Action Type	Date	Completed Date	Comment	Delete

Multiple Results Found

Field Office Compliance - Work Request

Work Request ID - 1204

Peters Mitchell - 310669002

1286 MARSH AVE. Little Rock, IA 51243

Lyon County

FO 3

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Facility Note

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Compliance Tracking