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Monthly Operation Report Forms

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 PDF File Format PDF File Format
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 PDF File Format PDF File Format
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 PDF File Format PDF File Format
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 PDF File Format PDF File Format


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: Charles Furrey, 515-725-0268, Charels.Furrey@dnr.iowa.gov
(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, 319-653-1623, 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)

 

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