Stormwater- Affiliates

Facility Name: VAN BERKEL FARMS - KOOI SITE

Permit Type: GP #2 - Construction Activity Legal Status: Private     File No: 19327   Authorization No: 19327-19098

Expiration Date: 10/15/2014 (discontinued) Address: 3786 ELMWOOD AVE. - SIOUX CENTER , IA 51250

County: SIOUX Field Office: 3 SIC: Geospatial Information: 231601(X)/4779073(Y)

Affiliates   Name Address City State Zip Phone Type LOREN VAN REGENMORTER 3881 EAGLE AVE. SIOUX CENTER IA 51250 (712)395-1415 Contact LOREN VAN REGENMORTER 3881 EAGLE AVE. SIOUX CENTER IA 51250 (712)395-1415 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