Stormwater- Checklist

Facility Name: AUDUBON COUNTY MEMORIAL HOSPITAL

Permit Type: GP #2 Legal Status: Private     File No: 2991   Authorization No: 2991-2825

Expiration Date: 7/19/1998 (discontinued) Address: 515 PACIFIC AVENUE - AUDUBON , IA 50025

County: AUDUBON Field Office: 4 SIC: Geospatial Information: 338826(X)/4620033(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 Only one PN received   Fee Memo