Stormwater- Affiliates

Facility Name: MONOGRAM PREPARED MEATS, LLC

Permit Type: GP #1 Legal Status: Private     File No: 19335   Authorization No: 19335-19106

Expiration Date: 11/30/2028(current) Address: 1231 W. 870TH ST. - HARLAN , IA 51537

County: SHELBY Field Office: 4 SIC: 2013 Geospatial Information: 305643(X)/4610848(Y)

Affiliates   Name Address City State Zip Phone Type BRETT ELLIOT     IA     Certifier MONOGRAM FOOD SOLUTIONS, LLC 530 OAK COURT DR. #400 MEMPHIS TN 38117 (765)532-4210 Owner JESSIE SMITH 1231 870TH ST. HARLAN IA 51537 (712)307-2365 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