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NPDES Application Forms for Individual Permits


Listed below are the permit application forms for individual non-stormwater NPDES permits to operate a wastewater disposal system and/ or to discharge industrial or domestic wastewater. These forms should not be used to apply for general permits for stormwater, onsite systems, mining and quarry operations, water well construction related wastewater, pesticide discharges, hydrostatic testing, tank ballasting, or water line discharges, dewatering activities, and residential geothermal discharges; or for permits for open or confined animal feeding operations. Please refer to the specific program webpages listed in the left-hand navigation bar to apply for a permit for any of these discharges.

Individual Permit Application Quick Links:

Industrial - Municipal/ Semi-public - Operation/ Land Application - Water Treatment - Other Useful Forms

Additional Information on Individual NPDES applications:

  • Submit all individual NPDES permit applications to the following email address: npdes.permit.application@dnr.iowa.gov. Email attachment size is limited to 25 MB. Please use zip files or other options to submit attachments greater than 25 MB and communicate that in your email submittal. Only individual permit applications will be accepted at this email address.
  • Part F of the individual municipal/semipublic permit application and Form 5 of the individual industrial permit application require signatures. Sign Part F or Form 5 according to the instructions, scan the form, attach it to an email, and send it with the other appropriate application forms to the previously noted email address. Electronic signatures are also acceptable.
  • Individual NPDES applications are due:
    • 180 days before an existing individual NPDES permit expires; or
    • at least 180 days prior to discharge for new dischargers (those who do not have an existing permit).
  • An application fee of $85 is required for all individual NPDES permit applications (renewal or new). Individual NPDES permit application fees and the completed fee invoices must be mailed to the Wallace Building at: Iowa DNR, 502 East 9th St., Des Moines IA 50319-0034.
  • In addition, all entities holding an industrial, non-industrial, or domestic NPDES permit are required to pay a facility-specific annual fee. Please refer to the NPDES Fees page for more information. 

General Permit Application Forms (Notices of Intent and Other Forms):

Animal Feeding Operation NPDES Permit Applications:

To apply for an NPDES permit for an Animal Feeding Operation, please go to the AFO Forms page.


Industrial Wastewater NPDES Permit Applications

Form 1 and Form 5 must be submitted by all industrial applicants together with one or more of the other four forms. Consult the General Information and Glossary of Terms to determine which forms are applicable to your discharge(s). Use the Industrial Application Review Checklist to make sure you have completed all necessary portions of the application. All forms contain instructions at the end. 

Industrial Application Forms DNR Form # Form Type and Link
General Information and Glossary - Applicability of forms and definitions of terms     PDF File Format
Industrial Application Review Checklist     PDF File Format
Form 1: General Information form. Required with Forms 2, 2F, 3, 4 and 5 542-1376 DOC File Format PDF File Format
Form 2: Facilities that do not discharge process wastewater (e.g. cooling water) 542-1377 DOC File Format PDF File Format
Form 2F: Facilities discharging stormwater associated with industrial activity 542-1380 DOC File Format PDF File Format
Form 3: Facilities discharging process wastewater - existing discharges 542-1378 DOC File Format PDF File Format
Form 4:  Facilities discharging process wastewater - new discharges 542-1379 DOC File Format PDF File Format
Form 5: Certification; required for all applicants 542-1382 DOC File Format PDF File Format

 

Industrial Application Forms contact: Wendy Hieb, wendy.hieb@dnr.iowa.gov


Operation Permit Applications

New - Applicants for new operation permits, including land application operation permits, must first submit the project for evaluation to the Iowa DNR's Wastewater Engineering Section (WES). Please proceed to the Land Application Permits webpage for more information on the land application permit process and the applicable forms.

Renewals - Operation permit renewals require the submittal of Forms 5 and 6. Electronic versions of these forms are available from your permit writer, as noted in your renewal letter.

Operation Permit Application Forms contact: Wendy Hieb, wendy.hieb@dnr.iowa.gov


Wastewater Discharges from Municipal Water Treatment Plants

Municipal water treatment plants discharging wastewater need coverage under an NPDES permit in addition to the water use permit requirements of Iowa DNR's Water Supply section. Water treatment plants must apply for an NPDES permit using the industrial wastewater forms. Please use the Supplemental Instructions below to determine which forms are needed.

Municipal Water Treatment Plant Application Forms Form Type and Link
Supplemental Application Instructions for Water Treatment Plants PDF File Format
Form 1, 3, 4, and 5: See links to forms under "Industrial Applications" See Links above

 

Municipal Water Treatment Plant NPDES Application Forms contact: Wendy Hieb, wendy.hieb@dnr.iowa.gov


Municipal and Semi-public NPDES Permit Applications (for Non-Industrial or Domestic Wastewater)

Form 30 Parts A and F must be submitted by all municipal or semi-public applicants. Form 30 Parts A - F are for use by publicly or privately-owned non-industrial systems that treat domestic sewage. Consult the Application Requirements to determine which forms are applicable to your discharge(s). Use the Application Review Checklist to make sure you have completed all necessary portions of the application. All forms contain instructions at the end.

Municipal and Semi-Public Application Forms DNR Form # Form Type and Link
Municipal and Semi-Public Application Requirements     PDF File Format
Municipal and Semi-Public Application Review Checklist     PDF File Format
Form 30, Part A: Basic Application Information; required for all applicants 542-3220 DOC File Format PDF File Format
Form 30, Part B: Expanded Effluent Testing Data 542-3220 XLS File Format
Form 30, Part C: Toxicity Testing Data 542-3220 DOC File Format PDF File Format
Form 30, Part D: Industrial User Discharges and RCRA/CERCLA wastes 542-3220 DOC File Format PDF File Format
Form 30, Part E: Combined Sewer Systems 542-3220 DOC File Format PDF File Format
Form 30, Part F: Certification; required for all applicants 542-3220 DOC File Format PDF File Format
Form 31, Treatment Agreement: Agreement between a city & an industry to treat wastewater 542-3221 DOC File Format PDF File Format

 

Municipal or Semi-Public Application Forms contact: Courtney Cswercko, courtney.cswercko@dnr.iowa.gov


Other Useful NPDES Forms

Below are other forms that may be useful during the NPDES permit application or renewal process.

Other Useful NPDES Forms DNR Form # Form Type and Link
Individual NPDES Permit Amendment Online Request Form: Request an amendment NA

Amendment Form

Temporary and Limited Degradation Online Request Form: Submit a Degradation request NA

Temp & Limited Form

Waiver Request Form: Request a waiver from permit monitoring requirements 542-1258 DOC File Format PDF File Format
Wasteload Allocation Request Form: Request a Wasteload Allocation 542-0106 DOC File Format PDF File Format
Acute Whole Effluent Toxicity Testing Report Form: Report acute WET testing results 542-1381 DOC File Format PDF File Format

 

Other NPDES Forms contact: Courtney Cswercko, courtney.cswercko@dnr.iowa.gov