Stormwater- Checklist

Facility Name: AIRGAS

Permit Type: GP #1 Legal Status: Private     File No: 22691   Authorization No: 22691-22444

Expiration Date: 10/1/2028(current) Address: 410 SE CREEKVIEW DR. - ANKENY , IA 50021

County: POLK Field Office: 5 SIC: 2813 Geospatial Information: 452250(X)/4619616(Y) (Electronic app)

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