Stormwater- Checklist

Facility Name: RAY-MAN, INC.

Permit Type: GP #1 Legal Status: Private     File No: 203   Authorization No: 203-1969

Expiration Date: 9/30/2028(current) Address: 515 E. BROADWAY - KEOTA , IA 52248

County: KEOKUK Field Office: 6 SIC: 3515 Geospatial Information: 587942(X)/4579715(Y)

Checklist 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 SEE CO/CV FOR REFUND OF $200.00 - OVERPAYMENT