Stormwater- Checklist

Facility Name: JEFFERSON COUNTY HEALTH CENTER - MEDICAL OFFICE ADDITION

Permit Type: GP #2 Legal Status: Public     File No: 22525   Authorization No: 22525-22286

Expiration Date: 9/24/2013 (discontinued) Address: 2000 S. MAIN ST. - FAIRFIELD , IA 52556

County: JEFFERSON Field Office: 6 SIC: Geospatial Information: 587628(X)/4537174(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