Stormwater- Affiliates

Facility Name: DALLAS COUNTY HOSPITAL

Permit Type: GP #2 Legal Status: Public     File No: 16236   Authorization No: 16236-16267

Expiration Date: 8/20/2010 (discontinued) Address: 610 10TH ST. - PERRY , IA 50220

County: DALLAS Field Office: 5 SIC: Geospatial Information: 409335(X)/4631619(Y)

Affiliates   Name Address City State Zip Phone Type RUSS SMITH 7300 WESTOWN PARKWAY WEST DES MOINES IA 50266 (515)276-8788 Contact DALLAS COUNTY HOSPITAL 610 10TH ST. PERRY IA 50220 (515)465-7600 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