Stormwater-

Facility Name: CLARION PACKAGING

Permit Type: No Exposure Legal Status: Private

Address: 1350 5TH AVE. SE - CLARION , IA 50525

County: WRIGHT Field Office: 2 SIC: 7021 Geospatial Information: 439830(X)/4731719(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