Stormwater- Affiliates

Facility Name: DIAMOND JO WORTH CASINO

Permit Type: GP #2 Legal Status: Private     File No: 12469   Authorization No: 12469-12248

Expiration Date: 9/19/2008 (discontinued) Address: 777 DIAMOND JO LANE - NORTHWOOD , IA 50459

County: WORTH Field Office: 2 SIC: Geospatial Information: 471249(X)/4810618(Y)

Affiliates   Name Address City State Zip Phone Type DIAMOND JO WORTH CASINO 777 DIAMOND JO LANE NORTHWOOD IA 50459 (641)323-7777 Owner MARK JENSEN 777 DIAMOND JO LANE NORTHWOOD IA 50459 (641)323-7777 Contact 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