Stormwater- Checklist

Facility Name: SAM'S CLUB #8162-04

Permit Type: GP #2 - Construction Activity Legal Status: Private     File No: 9379   Authorization No: 9379-9182

Expiration Date: 5/20/2007 (discontinued) Address: 2605 BLAIRS FERRY ROAD NE - CEDAR RAPIDS , IA 52402

County: LINN Field Office: 1 SIC: Geospatial Information: 609435(X)/4654460(Y)

Checklist Checklist Completed. Automatic Update NOI Received Fee Correct Facility Info PPP Developed Location Info PPP Comply Outfall Info Public Notice Received   Contact Info Public Notice Complete   Permit Type Info Signature   Fee Paid File Memo   Fee Memo