Project # 8618-2017

Contractor: Morris Excavating Co., Inc.
Contact Person: Jane Morris
Phone: (712) 366-4262

Owner: Casey's General Stores
Project Site: Casey's General Store #1077
Project Address: 600 S McArthur Ave
City: Salem
County: DENT
Regional Office: SERO
Demo Start Date: 07/27/2017
Demo Complete Date: 07/28/2017
Total # of Days: 1

Comments: Revised start date from 7/24/17 to meet 10 day waiting period;

Present Use: gas canopy
Prior Use: gas canopy
Asbestos Type: -
Asbestos Qty: -
Amendments: N/A
Inspections: N/A
Postmark Date: N/A
Date Received: 07/14/2017

Paid: Yes