Stormwater- Affiliates

Facility Name: MERCY MEDICAL CENTER NORTH IOWA

Permit Type: GP #2 Legal Status: Private     File No: 18755   Authorization No: 18755-18531

Expiration Date: 6/30/2012 (discontinued) Address: 1000 4TH ST. SW - MASON CITY , IA 50401

County: CERRO GORDO Field Office: 2 SIC: Geospatial Information: 482443(X)/4777683(Y)

Affiliates   Name Address City State Zip Phone Type HAL HUDSON 1000 4TH ST. SW MASON CITY IA 50401 (641)422-7230 Contact MERCY MEDICAL CENTER NORTH IOWA 1000 4TH ST. SW MASON CITY IA 50401 (641)422-7200 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