LUST Forms

Guidelines to Determine Site-Specific Parameters for Modeling the Fate and Transport of Monoaromatic Hydrocarbons in Groundwater
The objective of the guidelines report is to provide guidelines for determining site-specific parameters to model the fate and transport of dissolved groundwater pollutants. Ground water professionals will find this report helpful in cases where tier-3 assessments need to be conducted, and when additional site characterization is required to inform a choice about corrective action or remediation system design.  This report will emphasize modeling the fate and transport of benzene. This decision is based on the facts that benzene is the most toxic of the soluble components of gasoline, is more mobile than the other aromatic hydrocarbons, and is subject to the strictest cleanup standards because of its carcinogenic properties.  Thus, benzene concentrations often determine the need for remedial action at LUST sites. Nevertheless, the fundamental principles and procedures discussed herein are applicable to other groundwater contaminants commonly associated with petroleum product releases.

Methyl Tertiary-Butyl Ether (MTBE) Report
The Iowa Legislature passed 1999 Iowa Acts, House File 772 that contains a provision requiring soil and groundwater samples collected at leaking underground storage tank (LUST) site after July 1, 1999, be analyzed for methyl tertiary-butyl ether (MTBE).

• Table 1 - Physical and Chemical Properties of Oxygenates
• Table 2 - Percentages Samples Analyzed for MTBE by Sample Type
• Table 3 - MTBE Results from Groundwater Samples Collected at LUST Sites
• Table 4 - MTBE Results from Soil Samples Collected at LUST Sites
• Table 5 - MTBE Results in Receptor Samples at LUST Sites
• Table 6 - Other Oxygenates Detected in Samples at LUST Sites
• Figure 1 - MTBE Groundwater Clean-up Levels for LUST Sites
• Figure 2 - Distribution of MTBE Concentrations from Groundwater Samples
• Figure 3 - Percentage of LUST Sites Which Tested Groundwater for MTBE
• Figure 4 - Distribution of MTBE Groundwater Maximums at LUST Sites
• Figure 5 - Distribution of MTBE Concentrations from Soil Samples
• Figure 6 - Percentage of Lust Sites Which Tested Soil For MTBE
• Figure 7 - Distribution of MTBE Soil Maximums at LUST Sites

Abandoned Water Well Plugging Record (542-1226)
Abandoned Water Well Plugging Record (542-1226)

Allowable Discharge Concentration to Surface Water from a LUST Site (542-0273)
Allowable Discharge Concentration to Surface Water from a LUST Site (542-0273)

Corrective Action Design Report (CADR) Memorandum of Agreement
Corrective Action Design Report (CADR) Memorandum of Agreement

Corrective Action Design Report (CADR) Guidance

Corrective Action Design Report (CADR) Signature Page (542-0763)
Corrective Action Design Report (CADR) Signature Page (542-0763)

Free Product Recovery Report (542-1424)
Free Product Recovery Report (542-1424)

Free Product Recovery - Site Totals (542-1425)
Free Product Recovery - Site Totals (542-1425)

Hydraulic Conductivity (542-0262)

MTBE Sampling Results (542-1394)
MTBE Sampling Results (542-1394)

Post Tier 2 SCR Evaluation Worksheet Revision, Version 3-9/11 (542-0322)
Post Tier 2 SCR Evaluation Worksheet Revision, Version 3-9/11 (542-0322)

Sanitary Sewer Notification (542-1532)
Sanitary Sewer Notification (542-1532)

SMR Checklist (542-0475)
SMR Checklist (542-0475)

Site Check (542-1300)
Site Check (542-1300)

Site Monitoring Report (SMR) (Version 1.0)
Site Monitoring Report (SMR) (Version 1.0) 

Site Monitoring Report (SMR) Guide (Version 1.0)

Site Monitoring Report (SMR) (Version 2.2)
Site Monitoring Report (SMR) (Version 2.2) 

Site Monitoring Report (SMR) Guide (Version 2.2)

Soil Boring Log and Monitoring Well Construction Diagram (542-1392)
Soil Boring Log and Monitoring Well Construction Diagram (542-1392)

Tier 1 Accuracy Review Checklist (542-0615)
Tier 1 Accuracy Review Checklist (542-0615)

Tier 1 Report Completeness Review Checklist (542-0614)
Tier 1 Report Completeness Review Checklist (542-0614)

Tier 2 Report Completeness Checklist (542-0612)
Tier 2 Report Completeness Checklist (542-0612)

Tier 2 Site Cleanup Reports Accuracy Review Checklist (542-0613)
Tier 2 Site Cleanup Reports Accuracy Review Checklist (542-0613)

Tier 2 Report Form - The pages for the Tier 2 Report which are not printed from the software are now fillable PDF forms.

• Tier 2 Report Form (542-0166) |
• Tier 2 Signature Page (542-0723) |
• Field Screening Results Form (542-0531) |
• SMR Signature Page and Checklist (542-0762) |

Water Line - Utility Company Notification (542-1531)
Water Line - Utility Company Notification (542-1531)

Water Supply Notification (542-1530)
Water Supply Notification (542-1530) 

A web-based program for acquiring Iowa Geologic Survey Bureau (IGSB) well searches has been created for use in assessment and monitoring reports. Once registered, environmental professionals may access the site to conduct well searches at no charge.  To register for the new application, complete the following:

1. Go to the DNR Well Search web application 
2. Click on the link "To subscribe to Well Search" and register. Note: your username will be the email address you use to register.
3. Click on the Help button for directions to use the application

Within 24 hours you will receive a confirmation email indicating you have successfully registered to use the system. Well searches obtained by the new method are acceptable for use in reports effective immediately. 

Note: you are required to submit all sections of the well search report, including the map or aerial photo.

The quality control/quality assurance (QC/QA) procedures used during the site investigation must be at least as stringent as those contained in the LUST Quality Assurance Plan

Copies of IDNR's Leaking Underground Storage Tank Quality Assurance Plan may be obtained by calling 515-725-8336.  The groundwater professional must be able to provide IDNR with copies of the QC/QA plan designed for the site, field notes and chain of custody forms on request.