Stormwater-

Facility Name: PRIME PLATING

Permit Type: No Exposure Legal Status:

Address: 3900 ELM STREET - BETTENDORF , IA 52722

County: SCOTT Field Office: 6 SIC: 3471 Geospatial Information: 697362(X)/4613004(Y)

No Exposure Certification Application Date: MM/DD/YYYY Previously covered under a NPDES Storm Water permit? If yes, enter permit number: Certification Signed? Permit Type: --PERMIT TYPE-- GP #1 GP #2 GP #3 NO EXPOSURE SIC: Notes: Eligibility Confirmed Date: MM/DD/YYYY Not Eligible For Storm Water Exclusion Date: MM/DD/YYYY Application For Storm Water Exclusion Approved Date: MM/DD/YYYY Expiration Date Of Exclusion: MM/DD/YYYY