Stormwater- Affiliates

Facility Name: DALLAS COUNTY HOSPITAL

Permit Type: GP #2 Legal Status: Public     File No: 10690   Authorization No: 10690-10488

Expiration Date: 12/30/2007 (discontinued) Address: 610 10TH STREET - PERRY , IA 50220

County: BOONE Field Office: 5 SIC: Geospatial Information: 409159(X)/4631860(Y)

Affiliates   Name Address City State Zip Phone Type DALLAS COUNTY HOSPITAL 610 10TH STREET PERRY IA 50220 (515)465-7653 Owner SANDRA CHRISTENSEN 610 10TH STREET PERRY IA 50220 (515)465-7653 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