Stormwater- Affiliates

Facility Name: AIRGAS

Permit Type: GP #1 Legal Status: Private     File No: 22691   Authorization No: 22691-22444

Expiration Date: 10/1/2028(current) Address: 410 SE CREEKVIEW DR. - ANKENY , IA 50021

County: POLK Field Office: 5 SIC: 2813 Geospatial Information: 452250(X)/4619616(Y) (Electronic app)

Affiliates   Name Address City State Zip Phone Type TIM PETERSON 410 SE CREEKSIDE DR ANKENY IA 50021 (515)964-7087 Operator TIM PETERSON     IA     Certifier AIRGAS 410 SE CREEKVIEW DR SELECT ONE IA 50021 (515)964-7087 Owner DAVE GLOVER 410 SE CREEKVIEW DR. ANKENY IA 50021 (515)333-6491 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