Stormwater- Affiliates

Facility Name: VERN VAN BEEK - CONSTRUCTION

Permit Type: GP #2 - Construction Activity Legal Status: Private     File No: 9609   Authorization No: 9609-9404

Expiration Date: 9/30/2008 (discontinued) Address: 1921 270TH STREET - INWOOD , IA 51240

County: SIOUX Field Office: 3 SIC: Geospatial Information: 223751(X)/4794056(Y)

Affiliates   Name Address City State Zip Phone Type VERN VAN BEEK 2733 CHESTNUT INWOOD IA 51240 (712)470-1456 Contact VERN VAN BEEK 2733 CHESTNUT INWOOD IA 51240 (712)470-1456 Owner Individual? Type:* --AFFILIATE TYPE-- OWNER OPERATOR CONTACT CERTIFIER Name: Title:   Company Name: C/O:   Address: Address 2: City/State/Zip   --Select-- AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY PR OT E-mail:   Contact Owner   NO YES Preferred Method of contact EMAIL US MAIL Business Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Ext: Home Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Fax:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Mobile Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX