Stormwater- Affiliates

Facility Name: JEFFERSON COUNTY HEALTH CENTER - MEDICAL OFFICE ADDITION

Permit Type: GP #2 Legal Status: Public     File No: 22525   Authorization No: 22525-22286

Expiration Date: 9/24/2013 (discontinued) Address: 2000 S. MAIN ST. - FAIRFIELD , IA 52556

County: JEFFERSON Field Office: 6 SIC: Geospatial Information: 587628(X)/4537174(Y)

Affiliates   Name Address City State Zip Phone Type CARL A. NELSON & COMPANY 1815 DES MOINES AVE. BURLINGTON IA 52601 (319)754-8415 Contact JEFFERSON COUNTY HOSPITAL 2000 S. MAIN ST. FAIRFIELD IA 52556 (641)469-4301 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