Stormwater- Affiliates

Facility Name: JOHN'S QWIK STOP, GAS STATION - CONSTRUCTION

Permit Type: GP #2 Legal Status: Private     File No: 27994   Authorization No: 27994-27754

Expiration Date: 10/12/2021(expired) Address: 814 C AVE. - FORT MADISON , IA 52627

County: LEE Field Office: 6 SIC: Geospatial Information: 634773(X)/4497084(Y)

Affiliates   Name Address City State Zip Phone Type KETCHEN, INC. 101 WEST 4TH ST. VINTON IA 52349 (319)560-8103 Owner JOHN KETCHEN 101 WEST 4TH ST. VINTON IA 52349 (319)560-8103 Contact JOHN KETCHEN   VINTON IA 52349 (319)560-8103 Certifier 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