Stormwater- Checklist

Facility Name: K INDUSTRIES, INC.

Permit Type: GP #1 Legal Status: Private     File No: 1052   Authorization No: 1052-817

Expiration Date: 10/1/2027(current) Address: 1301 PINE ST. - JANESVILLE , IA 50647-0477

County: BLACK HAWK Field Office: 1 SIC: 2531 Geospatial Information: 544652(X)/4720586(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 SEE CO/CV FOR REFUND OF $850.00 - OVERPAYMENT