Stormwater- Checklist

Facility Name: SAFETY-KLEEN SYSTEMS, INC.

Permit Type: GP #1 Legal Status: Private     File No: 5309   Authorization No: 5309-5137

Expiration Date: 5/6/2031(current) Address: 4704 NE 22ND ST. - DES MOINES , IA 50313

County: POLK Field Office: 5 SIC: 7359 Geospatial Information: 451535(X)/4610597(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