Public Drinking Water Program
Public Water Supply Operation
Anne Lynam, Environmental Specialist Senior
Telephone: 515-725-0280, anne.lynam@dnr.iowa.gov
IDNR Public Water Supply Report forms:
Listed below are reporting forms used by public water supplies to report information to IDNR Water Supply Operation Section and/or the department's Field Offices.
| MORS: |
Form # |
*.xls |
*.pdf |
| Monthly operation reporting form for large surface water and influenced groundwater treatment facilities serving over 10,000 people. |
542-8030 thru 34 |
 |
 |
| Small (<10,000) Surface Water & IGW monthly operation report form |
542-8100 thru 07 |
 |
 |
| Consecutive surface water monthly operation report form |
542-8110 |
 |
 |
| Monthly operation report form for water supplies which are not surface water or influenced groundwater systems |
542-3104 |
 |
 |
| Consecutive ground water monthly operation report forms |
542-8099 |
 |
 |
| Sampling Plans: |
*.doc |
*.pdf |
| DBPR Monitoring Plan Template for groundwater and consecutive systems <10,000 population |
 |
 |
| TCR Bacterial Sampling Plan Template for system collecting one bacterial sample per month |
 |
 |
| TCR Sampling Plan Groundwater Rule Supplement |
 |
 |
| TCR Sampling Plan Groundwater Rule Supplement for Consecutive Systems |
 |
 |
| Other forms and guidance: |
*.doc |
*.pdf |
| Lead Consumer Notice for Community Systems |
 |
 |
| Lead Consumer Notice for Nontransient Noncommunity Systems |
 |
 |
| Lead and Copper Consumer Notice for Community Systems |
 |
 |
| Lead and Copper Consumer Notice for Nontransient Noncommunity Systems |
 |
 |
| Lead and Copper 90th Percentile Calculation Form |
 |
 |
| Water well abandonment reporting form: Abandoned Water Well Plugging Record, Form# 542-1226 |
 |
 |
Consumer confidence report guidance and templates:
- US EPA has designed software applications to help water suppliers create their consumer confidence reports;
CCRWriter (off-site)
- To obtain a copy of IAMU's template, contact Anne.Lynam@dnr.iowa.gov
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Public Notice Information:
Instructions (templates) and required language for notifying the public of monitoring and MCL violations.
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