The forms below are the standard monthly forms that operators of wastewater treatment facilities are expected to submit to the DNR.

The following forms are in PDF file format. You will need the Adobe Acrobat Reader installed on your computer to view the documents. If you cannot download the reader, you can receive copies of these application forms by sending your name, address, and the forms you want, to your local DNR field office.

	Form #	XLS	PDF
Wastewater Forms
Controlled Discharge Lagoon Facility Monthly Monitoring Report: The form for reporting monthly operating and monitoring data for lagoon systems under the NPDES operating permit system.	542-3230
Mechanical Plant Facility Monthly Monitoring Report: The form for reporting monthly operating and monitoring data for mechanical treatment systems under the NPDES operating permit system.	542-3231a
Industrial/Commercial Contributor Monitoring Report: The form for reporting monthly flow and monitoring information from an industrial contributor to an NPDES permitted facility.	542-3228a
Industrial/Commercial Contributor Monitoring Report (Metal Finishing): The form for reporting monthly flow and monitoring information about an industrial contributor involved in metal finishing that discharges to an NPDES permitted facility.	542-3228b

Facility-specific electronic MOR forms are available to all facilities through the DNR Field Offices. If you wish to obtain an electronic MOR specific to your facility that can be filled out and submitted via e-mail, please contact the following Field Office representatives:

Field Office 1, Manchester
Contact: Mike Wade, 563-927-2640, Mike.Wade@dnr.iowa.gov
(Howard, Winneshiek, Allamakee, Chickasaw, Fayette, Clayton, Bremer, Black Hawk, Buchanan, Delaware, Dubuque, Benton, Linn, Jones, and Jackson Counties)

Field Office 2, Mason City
Contact: Curt Krieger, 641-424-4073, Curt.Krieger@dnr.iowa.gov
(Kossuth, Winnebago, Worth, Mitchell, Hancock, Cerro Gordo, Floyd, Humboldt, Wright, Franklin, Butler, Webster, Hamilton, Hardin, and Grundy Counties)

Field Office 3, Spencer
Contact: Neil Cook, 712-262-4177, Neil.Cook@dnr.iowa.gov
(Lyon, Osceola, Dickinson, Emmet, Sioux, O'Brien, Clay, Palo Alto, Plymouth, Cherokee, Buena Vista, Pocahontas, Woodbury, Ida, Sac, and Calhoun Counties)

Field Office 4, Atlantic
Contact: Kirk Mathis, 712-243-1934, Kirk.Mathis@dnr.iowa.gov
(Monona, Crawford, Carroll, Greene, Harrison, Shelby, Audubon, Guthrie, Pottawattamie, Cass, Adair, Mills, Montgomery, Adams, Union, Fremont, Page, Taylor, and Ringgold Counties)

Field Office 5, Des Moines
Contact: 515-725-0268
(Boone, Story, Marshall, Tama, Dallas, Polk, Jasper, Poweshiek, Madison, Warren, Marion, Mahaska, Clarke, Lucas, Monroe, Decatur, Wayne, and Appanoose Counties)

Field Office 6, Washington
Contact: Russel Royce, 319-653-2135, Russel.Royce@dnr.iowa.gov
(Iowa, Johnson, Cedar, Clinton, Muscatine, Scott, Keokuk, Washington, Louisa, Wapello, Jefferson, Henry, Davis, Van Buren, Lee, and Des Moines Counties)