Stormwater- Checklist

Facility Name: CRAWFORD COUNTY MEMORIAL HOSPITAL

Permit Type: GP #2 Legal Status: Public     File No: 16452   Authorization No: 16452-16204

Expiration Date: 10/8/2011 (discontinued) Address: 2020 1ST AVE. SOUTH - DENISON , IA 51442

County: CRAWFORD Field Office: 4 SIC: Geospatial Information: 303188(X)/4655481(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