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NPDES Application Forms for Individual Permits

Listed below are the permit application forms for individual non-storm water 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 storm water, onsite systems, mining and quarry operations, water well construction related wastewater, or pesticide 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 any of these permits.

Individual Permit Application Quick Links:
Industrial - Municipal/ Semi-public - Operation/ Land Application - Water Treatment - Ag/Livestock Truck Wash


Additional Information on Individual NPDES applications:
    • 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).
    • 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.
Online Individual NPDES Permit Applications:

To apply for an NPDES permit online, please use the Wastewater Permits Information Exchange (WWPIE) System.  For more information on how to use WWPIE, refer to the WWPIE User Manual.

General Permit Application Forms (Notices of Intent): 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, 5, and the Supplement - Sulfate and Chloride Data must be submitted by all industrial applicants together with one or more of the other four forms.  Consult "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 of Terms - Information on applicability of industrial forms and definitions used throughout the forms     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. non-contact cooling water) 542-1377 
DOC File Format PDF File Format
Form 2F: Facilities discharging storm water 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
Supplement - Sulfate and Chloride Data  542-1383 
DOC File Format PDF File Format
NPDES Permit Application Chemical Analysis: Lab testing guidelines; for use with Form 3 or 4     PDF File Format

Industrial Application Forms contact: Wendy Hieb at 515-281-7804 or wendy.hieb@dnr.iowa.gov


Operation Permit Applications

Form 6 and Form 5 must be submitted by all applicants for an operation permit.  Use the "Operation Permit Application Review Checklist" to make sure you have completed all necessary portions of the application.  Applicants for new operation permits, including land application, must first submit the project for evaluation to DNR's Wastewater Engineering Section (WES).  More information can be found in the "Land Application Permit Manual" on the Wastewater Engineering webpage.
Operation Permit Application Forms DNR
Form #
Form Type and Link
General Information and Glossary of Terms - Information on applicability of forms and definitions used throughout the forms     PDF File Format
Operation Permit Application Review Checklist (for Form 6 only)     PDF File Format
Form 6: Operation permit application form  542-1390 
DOC File Format PDF File Format
Form 5 (for operation permits): Certification; required for all applicants   DOC File Format PDF File Format

Operation Permit Application Forms contact: Wendy Hieb at 515-281-7804 or wendy.hieb@dnr.iowa.gov


Livestock Truck Wash Land Application Permit Application (and example permit)

Form 7 must be submitted by all applicants to install and operate a land application system for disposal of livestock truck wash water.  Please refer to the example permit for Land Application for Livestock Truck Wash Water to determine if you qualify for coverage under this permit.
                            
Livestock Truck Wash Permit Application and Example Permit DNR
Form #
Form Type and Link
Form 7: Livestock Truck Wash Land Application Permit Application  542-0157 
DOC File Format PDF File Format
Example Permit to Install and Operate a Land Application System for Disposal of Livestock Truck Wash Water (Note: NOT an actual permit)  
PDF File Format

Land Application for Livestock Truck Wash Water Application Forms contact: Wendy Hieb at 515-281-7804 or 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 permit requirements of the DNR Water Supply section.  Water treatment plants must apply using the industrial wastewater forms.  Please use the "Supplemental Instructions" below to determine form applicability.

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 at 515-281-7804 or 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 application forms contain instructions at the end.

Municipal and Semi-Public Application Forms DNR
Form #
Form Type and Link
Municipal or Semi-Public Application Requirements     PDF File Format
Municipal or 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  DOC File Format PDF 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 Form: An agreement between a city and an industry to treat wastewater  542-3221 
DOC File Format PDF File Format
NPDES Permit Application Chemical Analysis: Laboratory testing guidelines; for use with Form 30, Part B and Part D
    PDF File Format

Municipal or Semi-Public Application Forms contact: Courtney Cswercko at 515-281-7206 or 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
Variance Request Form: Request variance from permit monitoring requirements  542-1258 
DOC File Format PDF File Format
Wasteload Allocation Request Form (Exhibit 3: Water Quality Based Permit Limits): Request a Wasteload Allocation   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 at 515-281-7206 or courtney.cswercko@dnr.iowa.gov



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