Stormwater- Checklist

Facility Name: DECATUR COUNTY HOSPITAL

Permit Type: GP #2 Legal Status: Public     File No: 19914   Authorization No: 19914-19686

Expiration Date: 7/1/2014(expired) Address: 1405 NW CHURCH ST. - LEON , IA 50144

County: DECATUR Field Office: 5 SIC: Geospatial Information: 437272(X)/4511302(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