Stormwater- Affiliates

Facility Name: FRANKLIN GENERAL HOSPITAL - REMODEL / ADDITION

Permit Type: GP #2 Legal Status: Public     File No: 17101   Authorization No: 17101-16877

Expiration Date: 5/1/2012 (discontinued) Address: 1720 CENTRAL AVE. EAST - HAMPTON , IA 50441

County: FRANKLIN Field Office: 2 SIC: Geospatial Information: 484640(X)/4732161(Y)

Affiliates   Name Address City State Zip Phone Type RANDY KIBSGAARD PO BOX 181 CLEAR LAKE IA 50428 (641)357-2283 Contact FRANKLIN GENERAL HOSPITAL 1720 CENTRAL AVE. EAST HAMPTON IA 50441 (641)456-5000 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