Stormwater- Checklist

Facility Name: ALEGENT HEALTH

Permit Type: GP #2 Legal Status: Private     File No: 4510   Authorization No: 4510-4348

Expiration Date: 9/18/2003 (discontinued) Address: 800 MERCY DRIVE - COUNCIL BLUFFS , IA 51502

County: POTTAWATTAMIE Field Office: 4 SIC: Geospatial Information: 262566(X)/4572344(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