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Get EPA Small MS4 Annual Report Form - Dnr Mo

TEM (MS4) STORMWATER MANAGEMENT PLAN REPORT DATE RECEIVED Part A MS4 PERMIT HOLDER INFORMATION 1. MS4 NAME 2. NPDES PERMIT NUMBER 3. MS4 UNIQUE ID NO. 4. ADDRESS 5. CITY 6. STATE 8. TELEPHONE NUMBER WITH AREA CODE 9. EMAIL 7. ZIP CODE 10. NAME OF MS4 CONTACT PERSON 11. Have any areas of the MS4 been added or removed from the MS4 jurisdiction due to annexation or other legal means since the most recent permit application (renewal, new, modification), or most recent MS4 stormwater.

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