Stormwater-

Facility Name: ZOETIS LLC

Permit Type: No Exposure Legal Status: Private

Address: 1020 NW 10TH ST. - EAGLE GROVE , IA 50533

County: WRIGHT Field Office: 2 SIC: 2834 Geospatial Information: 425645(X)/4724556(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