Forms, Applications, Permits and
Operations Manuals
Permits, Applications, Registration and Forms with Associated Documents
Or use the
search box above in the black bar to locate a form or publication on the DNR Web site. |
The Fill-in MS Word forms are usable in Microsoft Word, Microsoft Works, Open Office and other word processing software. These completed forms can be saved for updating for future submissions.
Fill in forms will accept only a limited amount of information in each individual box. If you need to insert more information than the form will accept, please use a supplemental sheet.
Any document listed is also available and can be requested by filling out the Publication Order Form or call 800-361-4827. Some of the items may have a cost associated with them. Additional environmental publications are online for cross reference.
Permit Assistant
If you're seeking an environmental permit, registration or certification for your business, school, community, or activity, the Missouri Department of Natural Resources' Permit Assistant can help! This tool is designed to help users determine what type of environmental permits they need and provide the forms to apply for these permits. This easy-to-use tool will ask you a few simple questions to determine your needs. Let's get started!
Laws and Regulations
General Information
- Field Services Operations Manual
- Water Pollution Control Permit Manual
- Environmental Permits and How to Obtain Them, Booklet--PUB98 (07/07) PDF
- Guide to Missouri Department of Natural Resources Permit Transfers, Booklet--PUB541 (08/06) PDF
- Understanding Environmental Regulations and Permits, Booklet--PUB595 (08/06) PDF
Air Pollution
Sales Tax Exemption forms are no longer processed by the Department of Natural Resources. Applicants should use DOR Form 149 Sales/Use Tax Exemption Certificate and issue them directly to seller. They do not need to be sent to the Department of Revenue.
- Proposed Test Plan Template RTF
Note: Use pages specific to process type unless unavailable then use generalized template pages. - Basic Operating Permit Compliance, Certification and Monitoring Report Form
and Instructions
This Missouri Air Conservation Commission approved a variance for Basic sources from 10 CSR 10-6.065(4)(I), Compliance Reporting, for the Annual Compliance Certifications due April 1, 2004. In other words, Basic installations do not need to submit Annual Compliance Certifications for 2003 that would be due April 1, 2004. - Dry Cleaner Notification of Compliance Status, Form--MO 780-1987 (04/08) Adobe PDF / Fill-in MS Word DOC
- GVIP Promotional Items Order Form, Form--MO 780-2031 (01/09) Adobe PDF / Fill-in MS Word DOC
- Intermediate Operating Permit Compliance, Certification and Monitoring Report Form--MO 780-1810 and Instructions (10/02) / Adobe PDF / Fill-in MS Word DOC
- PART 70 Operating Permit Compliance, Certification and Monitoring Report Form--MO 780-1808 and Instructions (07/08) / Adobe PDF / Fill-in MS Word DOC
- Notice of Violation/Excess Emissions 780-1640 (12/05) PDF
Ambient Air Monitoring
Ambient Air Quality Monitoring - Quality Assurance Project Plan (QAPP)
- QAPP Template (08/06) MS Word Template
- QAPP Template Instructions (08/06) MS Word
- QAPP Template Checklist (08/06) MS Word
- Asbestos Business Exemption Application, Form--MO 780-1222 (09/04) Adobe PDF / Fill-in MS Word DOC
- Asbestos Contractor Registration Application, Form--MO 780-1224 (08/04) Adobe PDF / Fill-in MS Word DOC
- Asbestos NESHAP Notification of Demolition and Renovation, Form--MO 780-1923 and Instructions (10/07) / Adobe PDF / Fill-in MS Word DOC
- Asbestos NESHAP Notification of Demolition and Renovation Amendment, Form--MO 780-1986 (04/08) Adobe PDF / Fill-in MS Word DOC
- Asbestos Notification Amendment, Form--MO 780-1556 (07/96) Adobe PDF / Fill-in MS Word DOC
- Asbestos Occupation Certification Application, Form--MO 780-1228 (01/07) Adobe PDF / Fill-in MS Word DOC
- Asbestos Occupation Certification Renewal, Form--MO 780-1227 (12/06) Adobe PDF / Fill-in MS Word DOC
- Asbestos Post-Notification, Form--MO 780-1225 (08/04) Adobe PDF / Fill-in MS Word DOC
- Asbestos Project Notification, Form--MO 780-1226 (05/05) Adobe PDF / Fill-in MS Word DOC
- Training Course Accreditation, Form--MO 780-1229 (11/06) Adobe PDF / Fill-in MS Word DOC
Asbestos Abatement Contractor Registration
Asbestos Removal Notification
- Asbestos Project Notification, Form--MO 780-1226 (05/05) Adobe PDF / Fill-in MS Word DOC
Concrete Batch Operation
Construction Permits (New Source Review Permits)
Please note: This application can be used for De Minimis, Minor Source, Major Source New Source Review/Prevention of Significant Deterioration (PSD) or Major New Source Review Hazardous Air Pollutant (HAP) Permits.
- Application for Authority to Construct, Packet--MO 780-1323 (02/07) and
Instructions (08/00) Adobe
PDF / Fill-in MS Word
DOC
- Form 2.0 Fill-in MS Word (Form 2.0 is an addendum to MO 780-1323. Duplicate this page for each emission point as needed. )
- Pre-construction Prohibition Waiver, Fact Sheet--PUB2014 (06/06) PDF
- Supplemental Information: Resources, References and Tables - Permit Application (02/06) PDF
- Pre-construction Prohibition Waiver, Fact Sheet--PUB2014 (02/06) PDF
Stage II Gasoline Vapor Recovery
- St. Louis County-Department of Health Vapor Recovery System Construction/Operating Permit Application (10/04) PDF
- Vapor Recovery System Construction/Operating Permit Application--MO 780-1561 (09/04) PDF
- City of St. Louis Vapor Recovery System Construction/Operating Permit Application PDF
- Emissions Banking and Trading, Form--MO 780-1875 (01/04) and Instructions (01/04) PDF
Emission Inventory Questionnaire (EIQ)
- Important Information for Missouri EIQ's (2008) DOC
- Overview of EIQ Forms (2008) DOC
- Glossary of EIQ Terms (2007) DOC
- Confidential EIQ Information Guidance (2008) PDF
- Section 112 Hazardous Air Pollutants (12/06) PDF
- Exempt VOC List (01/08) PDF
- Dry Cleaner - Non-Chlorinated and Petroleum Based Solvents, Form--MO 780-1954 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- Dry Cleaner Registration - Perchloroethylene and Other Chlorinated Solvents, Form--MO 780-1745 (11/06) and Instructions DOC / Adobe PDF / E-form
- EIQ Form 1.0 General Plant Information, Form--MO 780-1431 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 1.0 DS Submission of Revised Emission Totals and Additional Fees Owed, Form--MO 780-1574 (12/07) / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 1.1 Process Flow Diagram, Form--MO 780-1619 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 1.2 Summary of Emission Units and Related Processes, Form--MO 780-1620 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0 Emission Unit Information, Form--MO 780-1621 (02/08) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0C Control Device Information, Form--MO 780-1434 (02/08) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0K Charcoal Kiln Information, Form--MO 780-1530 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0L Landfill Worksheet, Form--MO 780-1583 (02/08) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC / Landfill Spreadsheet Excel
- EIQ Form 2.0P Portable Plant Information, Form--MO 780-1433 (12/07) and Instructions DOC/ Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0S Stack/Vent Information, Form--MO 780-1435 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0Z Ozone Season Information - "Emissions Statement," Form--MO 780-1452 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.1 Fuel Combustion Worksheet, Form--MO 780-1436 (12/07), Instructions DOC and Fuel Parameters Table PDF / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.2 Incinerator Worksheet, Form--MO 780-1438 (12/07), Instructions DOC and Classification of Waste Table PDF / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.3 VOC Process Mass-Balance Worksheet, Form--MO 780-1440 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.4 Volatile Organic Liquid Loading Worksheet, Form--MO 780-1625 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.5L General Liquid Storage Tank Information, Form--MO 780-1444 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.7 Haul Road Fugitive Emissions Worksheet, Form--MO 780-1445 (01/08), Instructions DOC and AP-42 13.2.2-1 Chart PDF / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.8 Storage Pile Worksheet, Form--MO 780-1446 (12/07), Instructions DOC and AP-42 13.2.4-1 Chart PDF / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.9 Stack Test/Continuous Emission Monitoring Worksheet, Form--MO 780-1447 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.T Hazardous Air Pollutant Worksheet, Form--MO 780-1448 (12/07) and Instructions and HAP List DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 3.0 Emissions Fee Calculation, Form--MO 780-1509 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 3.0CK Emissions Fee Calculation, Form--MO 780-1508 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 4.0 Financial Cost Estimate, Form--MO 780-1622 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
City of St. Louis
- EIQ Form 1.0 General Plant Information (City of St. Louis), Form--MO 780-1507 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
- EIQ Form 2.0 St. Louis City Emission Unit Information, Form--MO 780-1639 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
City of Kansas City
- EIQ Form 1.0 General Plant Information (City of Kansas City), Form--MO 780-1506 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
St. Louis County
- EIQ Form 1.0 General Plant Information (St. Louis County), Form--MO 780-1504 (12/07) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
City of Springfield
- EIQ Form 1.0 General Plant Information (City of Springfield), Form--MO 780-1502 (02/08) and Instructions DOC / Adobe PDF / Fill-in MS Word DOC
Gateway Vehicle Inspection Program
- Financial Waiver Eligibility Request, Form--MO 780-1970 (06/08) Adobe PDF / Fill-in MS Word DOC
- Cost-Based Waiver Application Affidavit - Repairs Made by a Repair Technichian, Form--MO 780-1971 (08/08) Adobe PDF / Fill-in MS Word DOC
- Mileage-Based Exemption Request, Form--MO 780-1972 (01/09) Adobe PDF / Fill-in MS Word DOC
- Cost-Based Waiver Application Affidavit - Repairs Made by a Vehicle Owner, Form--MO 780-1973 (08/08) Adobe PDF / Fill-in MS Word DOC
- Estimate-Based Waiver Application Affidavit - Estimate Provided by a Vehicle Repair Technician, Form--MO 780-1994 (06/08) Adobe PDF / Fill-in MS Word DOC
- Application for Permit to Open Burn Vegetative Waste, Form--MO 780-1941 (09/06) Adobe PDF / Fill-in MS Word DOC / E-form
- Application for Permit to Open Burn Vegetation With an Air Curtain Destructor (ACD) in the St. Louis Region*, Form--MO 780-1840 (09/03) PDF
- Facts on Open Burning Under Missouri Regulations, Fact Sheet--PUB2047 (06/06) PDF
Operating Permit Application Forms (Basic)
- Basic Operating Permit Notification, Form--MO 780-1872 and Instructions (08/08) Adobe PDF / Fill-in MS Word DOC
- Basic Operating Permit Notification, St. Louis Sources Only, Form--MO 780-1871 (12/03) Adobe PDF / Fill-in MS Word DOC
Operating Permit Application Forms (Part 70 and Intermediate/Synthetic Minor)
- Operating Permit, Form--MO 780-1519 (03/06) Adobe PDF / Fill-in MS Word DOC
- Operating Permit Instructions (02/03) DOC
Operating Permit Compliance, Certification and Monitoring Report Form
- Intermediate Operating Permit Compliance, Certification and Monitoring Report Form--MO 780-1810 and Instructions (10/02) / Adobe PDF / Fill-in MS Word DOC
- PART 70 Operating Permit Compliance, Certification and Monitoring Report Form--MO 780-1808 and Instructions (07/08) / Adobe PDF / Fill-in MS Word DOC
Operating Permits (Stage II Gasoline Vapor Recovery)
- Vapor Recovery System Construction/Operating Permit Application--MO 780-1561 (09/04) PDF
- St. Louis County-Department of Health Vapor Recovery System Construction/Operating Permit Application (10/04) PDF
- Application for Authority to Construct, Permit by Rule Notification - Crematories and Animal Incinerators, Form--MO 780-1888 (03/04) PDF
- Application for Authority to Construct, Permit by Rule Notification - Livestock Markets and Livestock Operations, Form--MO 780-1886 (03/07) Adobe PDF / Fill-in MS Word DOC
- Application for Authority to Construct, Permit by Rule Notification - Printing Operations, Form--MO 780-1889 (03/07) Adobe PDF / Fill-in MS Word DOC
- Application for Authority to Construct, Permit by Rule Notification - Surface Coating Operations, Form--MO 780-1887 (03/07) Adobe PDF / Fill-in MS Word DOC
Portable Source Relocation Request
- Application for Authority to Construct, Packet--MO 780-1323 (02/07) and Instructions (08/00) Adobe PDF / Fill-in MS Word DOC - Portable Source Relocation forms are found on pages 14-16 of the Application for Authority to Construct
- Form 2.0 Fill-in MS Word (Form 2.0 is an addendum to MO 780-1323. Duplicate this page for each emission point as needed.
- City of St. Louis Vapor Recovery System Construction/Operating Permit Application PDF
- Delivery Vessel Pressure Test Certification Application, Form--MO 780-1262 (01/05) PDF
- Request for Exemption
Stage 1 Requirement Regulation 10 CSR 10-5.220, (4) - St. Louis; 10 CSR 10-2.260, (3) - Kansas City
Bulk Plants / "Gasoline Loading", Form--MO 780-1528 (01/05) PDF - St. Louis County-Department of Health Vapor Recovery System Construction/Operating Permit Application (10/04) PDF
- Vapor Recovery System Construction/Operating Permit Application--MO 780-1561 (09/04) PDF
Dam Safety
- Dam Inventory Questionnaire, Form--MO 780-1755 (03/04) Adobe PDF / Fill-in MS Word DOC
- Application for Construction Permit, Form--MO 780-1763 (03/04) Adobe PDF / Fill-in MS Word DOC
- Certification - Construction Permit Application, Form--MO 780-1764 (03/04) Adobe PDF / Fill-in MS Word DOC
- Certification - Registration Permit Application, Form--MO 780-1756 (03/04) Adobe PDF / Fill-in MS Word DOC
- Application for Registration Permit, Form--MO 780-1758 (03/04) Adobe PDF / Fill-in MS Word DOC
- Application to Renew Registration Permit, Form--MO 780-1757 (03/04) Adobe PDF / Fill-in MS Word DOC
- Application for Safety Permit, Form--MO 780-1759 (03/04) Adobe PDF / Fill-in MS Word DOC
- Certification - Safety Permit Appliction, Form--MO 780-1760 (03/04) Adobe PDF / Fill-in MS Word DOC
- Application to Renew Safety Permit, Form--MO 780-1761 (03/04) Adobe PDF / Fill-in MS Word DOC
- Agricultural Exemption Information Sheet, Form--MO 780-1765 (03/04) Adobe PDF / Fill-in MS Word DOC
- Inquiry and Information, Form--MO 780-1762 (03/04) Adobe PDF / Fill-in MS Word DOC
Construction Permit Checklists
- Construction Permit Application - Earth Dam PDF
- Construction Permit Application - Modification to Existing Earth Dam PDF
- Construction Permit Application - Industrial Water Retention Dam PDF
Registration and Safety Permits Checklists
- Registration Permit Application - Earth Dam PDF
- Registration Permit Application - Industrial Water Retention Dam PDF
- Safety Permit Application - Earth Dam PDF
- Safety Permit Application - Industrial Water Retention Dam PDF
Energy and Renewable Energy
Energy Revolving Fund
- Energy Revolving Fund, Booklet--PUB1223
(Full Printable Version) (08/05) PDF
- Application, Fuel Use Summary, Form--MO 780-1169 (05/08) PDF / Fill-in MS Word DOC
- Wall or Ceiling Insulation Worksheet, Form--MO 780-1361 (08/05) Fill-in Adobe PDF / Fill-in MS Word DOC
- Pipe Insulation Worksheet, Form--MO 780-1362 (08/05) Fill-in Adobe PDF / Fill-in MS Word DOC
- Heat Loss Factor Table--MO 780-0891 (08/05) Adobe PDF / MS Word DOC
- Programmable Setback Thermostat Worksheet, Form--MO 780-1360 (08/05) Fill-in Adobe PDF / Fill-in MS Word DOC
- Lighting Upgrade Worksheet, Form--MO 780-1359 (08/05) Fill-in Adobe PDF / Fill-in MS Word DOC
- Window Replacement/Window Reduction Worksheet, Form--MO 780-1363 (08/05) Fill-in Adobe PDF / Fill-in MS Word DOC
- Heating Plant and Cooling Plant Replacement Worksheets, Form--MO 780-1358 (08/05) Fill-in Adobe PDF / Fill-in MS Word DOC
- Reimbursement Form--MO 780-1170 (11/08) Adobe PDF / Fill-in MS Word DOC
- Final Project Cost Report, Form--MO 780-1172 (11/08) Adobe PDF / Fill-in MS Word DOC
CAIR Annual NOx Set-Aside
- Request for Pre-Application Project Review, Missouri Energy Efficiency and Renewable Energy CAIR Annual NOx Set-Aside, Form--MO 780-1979 (12/07) PDF
- Application for An Awawrd Of Allowances From Missouri Energy Efficiency and Renewable Energy CAIR Annual NOx Set-Aside, Form--MO 780-1978 (12/07) PDF
- Application for Subsequent Year Award Of Allowances From Missouri Energy Efficiency and Renewable Energy CAIR Annual NOx Set-Aside, Form--MO 780-1977 (12/07) PDF
Home Energy Auditor Certification
- Missouri Certified Home Energy Auditor Application (Existing BPI Or RESNET Certification), Form--MO 780-2011 and Instructions (11/08) Adobe PDF / Fill-in MS Word DOC
- Missouri Certified Home Energy Auditor Application (Provisional Certification), Form--MO 780-2012 and Instructions (11/08) Adobe PDF / Fill-in MS Word DOC
- Missouri Certified Home Energy Auditor Application (Training institution), Form--MO 780-2013 and Instructions (11/08) Adobe PDF / Fill-in MS Word DOC
- Missouri Certified Home Energy Auditor Application ( Training at institution other than BPI or RESNET ), Form--MO 780-2014 and Instructions (11/08) Adobe PDF / Fill-in MS Word DOC
Missouri Energy Efficiency and Renewable Energy NOx SIP Set-Aside
- Request for Early Review of Project Eligibility for Summer 2006, Form--MO 780-1938 (10/05) PDF
- Application for Spring 2007 Award, Form--MO 780-1482 (10/05) PDF
- Reapplication for Award, Form--MO 780-1937 (10/05) PDF
Other Energy Forms
- Dial-A-Ride Action Card, Form--MO 780-0950 (06/04) PDF
- Wood Energy Tax Credit Application, Form--MO 780-1305 (02/08) PDF
Financial Assistance Center
- Applicant Assurance Local Funding (07/06) Adobe PDF / Fill-in MS Word DOC
- State Revolving Fund Certificate of Title to Site (07/06) Adobe PDF / Fill-in MS Word DOC
Clean Water
- Clean Water Forty Percent Grant Application, Form--MO 780-2001 and Instructions (09/08) Adobe PDF / Fill-in MS Word DOC
- Clean Water Pre-closing Document Submittal Checklist (07/06) Adobe PDF / Fill-in MS Word DOC
- Clean Water State Revolving Fund Application, Form--MO 780-1951and Instructions (09/08) Adobe PDF / Fill-in MS Word DOC
- Clean Water State Revolving Fund Governing Body Resolution for Authorized Representative (07/06) Adobe PDF / Fill-in MS Word DOC
- Clean Water State Revolving Fund Applicant Assurance of Easements (07/06) Adobe PDF / Fill-in MS Word DOC
- Clean Water Facility Plan Submittal Checklist (07/06) Adobe PDF / Fill-in MS Word DOC
- Clean Water Statement of Work Completed (07/06)Adobe PDF / Fill-in MS Word DOC
- Facility Plan/Environmental Information Document Guidance for Clean Water State Revolving Fund (SRF) Funded Projects PDF
- Guidance on Summary of Design Data Memo for Construction Plans and Specifications for Clean Water State Revolving Fund (SRF) Funded Projects PDF
- Land Acquisition and Relocation Guidance PDF
Drinking Water
- Drinking Water State Revolving Fund Pre-closing Document Submittal Checklist (07/06) Adobe PDF / Fill-in MS Word DOC
- Drinking Water State Revolving Fund Governing Body Resolution for Authorized Representative (07/06) Adobe PDF / Fill-in MS Word DOC
- Drinking Water State Revolving Fund Applicant Assurance of Easements (07/06) Adobe PDF / Fill-in MS Word DOC
- Drinking Water Facility Plan Submittal Checklist (07/06) Adobe PDF / Fill-in MS Word DOC
- Land Acquisition and Relocation Guidance PDF
Geology
- Publication Order--MO 780-1730 (08/07) PDF
- Request for Geohydrologic Evaluation of Liquid-Waste Treatment Facility/Site, Form--MO 780-1688 (01/09) Adobe PDF / Fill-in MS Word DOC
- Request for Geohydrologic Evaluation of Residential Housing Development (Subdivision), Form--MO 780-1690 (04/03) Adobe PDF / Fill-in MS Word DOC
- Request for Preliminary Investigation of Area Proposed for Beneficial Reuse of Solid Waste, Form--MO 780-1691 (04/03) Adobe PDF / Fill-in MS Word DOC
- Request for Preliminary Investigation of Proposed Solid-Waste Disposal Area, Form--MO 780-1689 (05/07) Adobe PDF / Fill-in MS Word DOC
- Water Trace Information Sheet Injection Point, Form--MO 780-1693 (04/03) Adobe PDF / Fill-in MS Word DOC
- Water Trace Information Sheet Monitoring Point, Form--MO 780-1694 (04/03) Adobe PDF / Fill-in MS Word DOC
- Water Trace Information Sheet Water Tracer Registration Application, Form--MO 780-1695 (04/03) Adobe PDF / Fill-in MS Word DOC
- Certified Land Corner Document, Form--MO 780-1708 (08/08) Adobe PDF / Fill-in MS Word DOC / CAD DWG
- EDM Calibration Report - Vichy EDM Baseline (Slope)--MO 780-1870 (08/07) PDF
- EDM Calibration Report - Vichy EDM Baseline (Horizontal)--MO 780-1869 (08/07) PDF
- EDM Calibration Report - Taylor EDM Baseline (Slope)--MO 780-1868 (08/07) PDF
- EDM Calibration Report - Taylor EDM Baseline (Horizontal)--MO 780-1867 (08/07) PDF
- EDM Calibration Report - Squaw Creek EDM Baseline (Slope)--MO 780-1866 (08/07) PDF
- EDM Calibration Report - Squaw Creek EDM Baseline (Horizontal)--MO 780-1865 (08/07) PDF
- EDM Calibration Report - Springfield EDM Baseline (Slope)--MO 780-1864 (08/07) PDF
- EDM Calibration Report - Springfield EDM Baseline (Horizontal)--MO 780-1863 (08/07) PDF
- EDM Calibration Report - River Valley EDM Baseline (Slope)--MO 780-1862 (08/07) PDF
- EDM Calibration Report - River ValleyEDM Baseline (Horizontal)--MO 780-1861 (08/07) PDF
- EDM Calibration Report - Pomona EDM Baseline (Slope)--MO 780-1860 (08/07) PDF
- EDM Calibration Report - Pomona ValleyEDM Baseline (Horizontal)--MO 780-1859 (08/07) PDF
- EDM Calibration Report - Perryville EDM Baseline (Slope)--MO 780-1858 (08/07) PDF
- EDM Calibration Report - Perryville EDM Baseline (Horizontal)--MO 780-1857 (08/07) PDF
- EDM Calibration Report - Lake City EDM Baseline (Slope)--MO 780-1856 (08/07) PDF
- EDM Calibration Report - Lake City EDM Baseline (Horizontal)--MO 780-1855 (08/07) PDF
- EDM Calibration Report - Kirksville EDM Baseline (Slope)--MO 780-1854 (08/07) PDF
- EDM Calibration Report - Kirksville EDM Baseline (Horizontal)--MO 780-1853 (08/07) PDF
- EDM Calibration Report - Jasper County EDM Baseline (Slope)--MO 780-1852 (08/07) PDF
- EDM Calibration Report - Jasper County EDM Baseline (Horizontal)--MO 780-1851 (08/07) PDF
- EDM Calibration Report - Dexter EDM Baseline (Slope)--MO 780-1850 (08/07) PDF
- EDM Calibration Report - Dexter EDM Baseline (Horizontal)--MO 780-1849 (08/07) PDF
- EDM Calibration Report - Cedar EDM Baseline (Slope)--MO 780-1848 (08/07) PDF
- EDM Calibration Report - Cedar EDM Baseline (Horizontal)--MO 780-1847 (08/07) PDF
Hazardous Waste
Drycleaning Environmental Response Trust (DERT)
- DERT Fund - Consent for Access to Property, Form--MO 780-1945 (04/06) PDF
- Dry Cleaning Facility Change of Ownership, Form--MO 780-1877 (01/07) Adobe PDF / Fill-in MS Word DOC
- Dry Cleaner Registration - Perchloroethylene and Other Chlorinated Solvents, Form--MO 780-1745 (11/06) and Instructions DOC / Adobe PDF / E-form
- Dry Cleaning Solvent Surcharge Calculation Sheet (Part 1 and Part 2), Form--MO 780-1725 (10/08) Adobe PDF / Fill-in MS Word DOC / E-form
- Missouri Drycleaning Environmental Response Trust (DERT) Fund Application, Form--MO 780-1837 (09/05) Adobe PDF / Fill-in MS Word DOC
- Notice of Closure of a Dry Cleaning Facility, Form--MO 780-1876 (03/06) Adobe PDF / Fill-in MS Word DOC
- Notification for the Existence or Former Existence of a Dry-cleaning Facility--MO 780-1831 (08/05) Adobe PDF / Fill-in MS Word DOC
- Prioritization Ranking, Form--MO 780-1894 (11/05) Adobe PDF / Fill-in MS Word DOC
- Reimbursement Claim Worksheet, Form--MO 780-1891 (09/05) PDF
Brownfields/Voluntary Cleanup
- Brownfields Assessment Application, Form--MO 780-1955 (12/06) PDF
- Brownfields/Voluntary Cleanup Program (BVCP) Application, Form--MO 780-1712 (07/06) Fill-in PDF
- Consent for Access to Property, Form--MO 780-1713 (12/06) PDF
e-cycle Missouri
- Host Site Registration, Form--MO 780-1981 (12/07) Adobe PDF / Fill-in MS Word DOC
- Host Site Self-Audit, Form--MO 780-1980 (12/07) Adobe PDF / Fill-in MS Word DOC
Hazardous Waste Treatment, Storage and Disposal Facilities and Resource Recovery Facilities
- Certified Resource Recovery Facility Application, Form--MO 780-1163 (09/06) Instructions PDF
- EPA RCRA Hazardous Waste Part A Permit Application -- EPA 8700-23 PDF
- Habitual Violator Disclosure Statement, Form--780-1966 (07/07) PDF
- Missouri Hazardous Waste Management Facility Application Form PDF
- Generator's Hazardous Waste Summary Report, Part I and II, Form--MO780-1097 (06/08) / Adobe PDF / Fill-in MS Excel XLS
- Facility Summary Report, Part I and II, Form--MO 780-0408 (11/07) / Adobe PDF / Fill-in MS Excel XLS
- Hazardous Waste Generator's Exception Report, Form--MO 780-0651 (09/06) PDF
- Large Quantity Generator Inspection Checklist, Form--MO 780-1525 (01/09) Adobe PDF / Fill-in MS Word DOC
- Notification of
Regulated Waste Activity, E-form--MO 780-1164 (01/08) Adobe PDF / E-form
A $100 fee is required for all new registrations or to re-activate a currently inactive registration. - Small Quantity Generator Inspection Checklist, Form--MO 780-1602 (01/098) Adobe PDF / Fill-in MS Word DOC
Hazardous Waste Transporter License
- Now issued by MoDOT, Motor Carrier Services Unit http://www.modot.org/mcs/index.htm
Polychlorinated Biphenyl (PCB) Facility
Underground Storage Tank (UST) (includes underground petroleum storage tank)
- Information regarding underground storage tank systems
- Underground Storage Tank (UST) Temporary Closure Checklist, Form--MO 780-1974 (10/07) PDF
- Notification - Installation of New Underground Storage Tank System, Form--MO 780-1949 (09/08) Adobe PDF / Fill-in MS Word DOC
- Petroleum Storage Tank Registration, Form and Instructions--MO 780-1782 (08/08) Adobe PDF / Fill-in MS Word DOC
- Request for Underground Storage Tank Records, Form--MO 780-1968 (08/07) PDF
- Tank Piping Information Instructions PDF
- Transporter's Used Oil Annual Report, Form--MO 780-1555 and Instructions (07/08) Adobe PDF / Fill-in MS Word DOC
- Transporter's Used Oil Shipment Record, Form--MO 780-1449 (04/07) PDF
- Used Oil Aggregation Point Facility, Inspection and Record Checklist, Form--MO 780-1523 (06/04) PDF
- Used Oil Burners Who Burn Off-Specification Used Oil for Energy Recovery, Inspection and Record Checklist, Form--MO 780-1520 (06/04) PDF
- Used Oil Collection Center, Inspection and Record Checklist, Form--MO 780-1524 (06/04) PDF
- Used Oil Fuel Marketers, Inspection and Record Checklist, Form--MO 780-1526 (06/04) PDF
- Used Oil Generator, Inspection Record and Checklist, Form--MO 780-1890 (10/04) PDF
- Used Oil Processors and Re-Refiners, Inspection and Record Checklist, Form--MO 780-1521 (06/04) PDF
- Used Oil Transporter and Transfer Facilities, Inspection and Record Checklist, Form--MO 780-1522 (06/04) PDF
Historic Preservation (includes Section 106)
- Archaeological Site Recordation, Form--MO 780-1927 (07/05) Adobe PDF / Fill-in MS Word DOC / E-mail Form
- Section 106 Project Information Form--MO 780-1027 (09/02) Fill-in PDF
- Section 106 Survey Memo Form--MO 780-1718 (06/00) Fill-in PDF and Instructions PDF
Human Resources
- Application for Temporary Employment, Form--MO 780-1601 (07/08) Adobe PDF / Fill-in MS Word DOC
- Summer Professional Development Program Application, Form--MO 780-2009 (10/08) Adobe PDF / Fill-in MS Word DOC
- Summer Professional Development Program Recommendation Letter, Form--MO 780-2010 (10/08) Adobe PDF / Fill-in MS Word DOC
Land Reclamation
Coal Exploration Permit
- Forms available by contacting the Land Reclamation Program at 573-751-4041.
Industrial Mineral Surface Mining Permits
In-Stream Sand and Gravel Operations
Forms
- In-Stream Sand and Gravel Operations, Instructions and Definitions Form--MO 780-1742 (10/07) PDF
- Permit Application for Industrial Mineral Mines, Form--MO 780-1007 (08/07) PDF
- Consent to Entry, Form--MO 780-1329 (05/02) PDF
- Permit Transfer, Form--MO 780-1333 (05/02) PDF
- Company Information, Form--MO 780-1928 (02/07) PDF
- Public Notice to Local Newspaper and Certified Mail to Adjacent Landowners
and Government Bodies
- New Permit (08/07) PDF
- Renewal (08/07)PDF
- Revision (08/07) PDF
- Transfer (08/07) PDF
- Expansion (08/07) PDF
- Transfer-Expansion (08/07) PDF
- Site Information Form--MO 780-1036 (12/02) PDF
- Sand and Gravel Excavation Plan--MO 780-1895 (08/05) PDF
- Permit Renewal Form for Industrial Mineral Mines, Form--MO 780-1780 (07/07) PDF
- Annual Operations Status Report, Form--MO 780-1884 (03/07) Adobe PDF / Fill-in MS Word DOC
Examples
- Permit Application for Industrial Mineral Mines, Form--MO 780-1007 (08/07) PDF
- Site information Form--MO 780-1036 (12/02) PDF
Renewal Packet for In-Stream Sand and Gravel
Other
Forms
- Open Pit Operations, Instructions and Definitions Form--MO 780-1743 (07/07) PDF
- Permit Application for Industrial Mineral Mines, Form--MO 780-1007 (08/07) PDF
- Consent to Entry, Form--MO 780-1329 (05/02) PDF
- Permit Transfer, Form--MO 780-1333 (05/02) PDF
- Company Information, Form--MO 780-1928 (02/07) PDF
- Public Notice to Local Newspaper and Certified Mail to Adjacent Landowners
and Government Bodies
- New Permit (08/07) PDF
- Renewal (08/07) PDF
- Revision (08/07) PDF
- Transfer (08/07) PDF
- Expansion (08/07) PDF
- Transfer-Expansion (08/07) PDF
- Site Information Form--MO 780-1036 (12/02) PDF
- Mine Plan, Form--MO 780-1327 (05/02) PDF
- Surety Bond Surface Mining of Minerals, Form--MO 780-0016 (10/01) PDF
- Personal Bond Secured by A Certificate of Deposit, Form--MO 780-0936 (10/01) PDF
- Assignment of Certificate of Deposit, Form--MO 780-1342 (10/01) PDF
- Personal bond with Irrevocable letter of Credit, Form--MO 780-1472 (10/01) PDF
- Confirmation of Irrevocable Letter of Credit, Form--MO 780-0015 (10/01) PDF
- Permit Renewal Form for Industrial Mineral Mines, Form--MO 780-1780 (07/07) PDF
- Geologic Resources Fee Worksheet, Form--MO 780-1965 (09/08) PDF
- Request for Approval of Reclaimed Land, Form--MO
780-0946 (05/02) PDF
- Notice of Request for Approval of Reclaimed Land (06/05) PDF
- Status Report, Form--MO 780-1885 (03/04) PDF
Examples
- Permit Application for Industrial Mineral Mines, Form--MO 780-1007 (08/07) PDF
- Site information Form--MO 780-1036 (12/02) PDF
- Mine Plan, Form--MO 780-1327 (05/02) PDF
Renewal Packet for Open Pit
Other
- Chapter 10 - Permit and Performance Requirements for Industrial Minerals Open Pit and In-Stream Sand and Gravel OperationsPDF
- Land Reclamation Act - 444.760 - 444.790 PDF
Metallic Mineral Waste Management Permit
Permit consists of an Inspection-Maintenance and Closure Plan that is available by contacting the Land Reclamation Program at 573-751-4041.
Surface Coal Mine and Reclamation Permit
Forms available by contacting the Land Reclamation Program at 573-751-4041.
Major Water Users
- Annual Water Use Report Form For Irrigators E-mail Form
- Annual Water Use Report Form For Non-Irrigators E-mail Form
- Data Request Form, Form--MO 780-2015 (11/08) Adobe PDF / Fill-in MS Word DOC
- Major Water Use Registration Form, Form--MO 780-2019 (12/08) Adobe PDF / Fill-in MS Word DOC
- Major Water Use Registration Form For Mines and Quarries, Form--MO 780-2020 (12/08) Adobe PDF / Fill-in MS Word DOC
Oil and Gas
- Organization Report, Form--MO 780-0209 (06/07) Form OGC-1 Adobe PDF / Fill-in MS Word DOC
- Surety Bond, Form--MO 780-0210 (06/06) Form OGC-2 Adobe PDF / Fill-in MS Word DOC
- Personal Bond - Secured by a Certificate of Deposit, Form--MO 780-1777 (06/06) Form OGC-2A Adobe PDF / Fill-in MS Word DOC
- Application for Permit to Drill, Deepen, or Plug Back, Form--MO 780-0211 (08/06) Form OGC-3 Adobe PDF / Fill-in MS Word DOC
- Injection Well Permit Application (To Drill, Deepen, Plug Back, or Convert an Existing Well), Form--MO 780-0212 (06/06) Form OGC-3I Adobe PDF / Fill-in MS Word DOC
- Well Location Plat, Form--MO 780-0213 (06/06) Form OGC-4 Adobe PDF / Fill-in MS Word DOC
- Injection Well Location Plat, Form--MO 780-1136 (09/01) Form OGC-4I Adobe PDF / Fill-in MS Word DOC
- Well Completion or Recompletion Report and Well Log, Form--MO 780-0215 (08/06) Form OGC-5 Adobe PDF / Fill-in MS Word DOC
- Notice of Intention to Abandon Well, Form--MO 780-0214 (06/06) Form OGC-6 Adobe PDF / Fill-in MS Word DOC
- Plugging Record, Form--MO 780-0217 (06/06) Form OGC-7 Adobe PDF / Fill-in MS Word DOC
- Well Conversion Agreement, Form--MO 780-0218 (06/06) Form OGC-8 Adobe PDF / Fill-in MS Word DOC
- Monthly Well Status and Production Report, Form--MO 780-0219 (06/06) Form OGC-9 Adobe PDF / Fill-in MS Word DOC
- Monthly Report of Disposal of Produced Water, Form--MO 780-0220 (09/01) Form OGC-10 Adobe PDF / Fill-in MS Word DOC
- Injection Well Schematic, Form--MO 780-0221 (08/06) Form OGC-11 Adobe PDF / Fill-in MS Word DOC
- Injection Well Monitoring Report, Form--MO 780-0208 (08/06) Form OGC-12 Adobe PDF / Fill-in MS Word DOC
Operator Certification and Training
- Application: For Examination for a Water Treatment, Water Distribution, Wastewater Operator or Concentrated Animal Feeding Operations (CAFO) Certificate--MO 780-1089 (11/06) PDF
- Application: For Reciprocity of a Water Treatment, Water Distribution, Wastewater or Concentrated Animal Feeding Operations (CAFO) Operator Certificate--MO 780-1091 (07/04) PDF
- Contract Operator Form, Form--MO 780-2002 (09/08) Adobe PDF / Fill-in MS Word DOC
- Request for Training and Course Approval, Form--MO 780-1892 (07/04) PDF
Public Drinking Water
- Disinfection and Turbidity Report for Surface Water Systems > 10,000 Population, Form--MO 780-1591 (10/06) PDF
- Disinfection and Turbidity Report for Surface Water Systems < 10,000 Population, Form--MO 780-1904 (10/06) PDF
- Drinking Water State Revolving Fund Loan Application, Form--MO 780-1845 and Instructions (11/08) Adobe PDF / Fill-in MS Word DOC
- Microbiological Analysis Report, Form--MO 780-0438 (10/06) PDF
- Missouri Drinking Water Primacy Fee Report, Form--MO 780-1380 (08/06) Adobe PDF / Fill-in MS Word DOC
Certification
- Construction Permit Application, Form--MO 780-0701 (03/07) PDF
- Backflow Prevention Assembly Test Data and Maintenance Report, Form--MO 780-0804 (01/06) Adobe PDF / Fill-in MS Word DOC
- Application For Permit To Dispense Water
Solid Waste
These forms are also available on the Solid Waste Management Web page at www.dnr.mo.gov/env/swmp/forms/form_permit.htm.
- General Information on Solid Waste permits PDF
- Recycled Content Newsprint Usage Exemption, Form--MO 780-1453 (01/08) PDF
- Recycled Content Newsprint Usage Statement, Form--MO 780-1455 (01/08) PDF
- Solid Waste Technician Certification Class Enrollment Form--MO 780-2000 (07/08) Adobe PDF / Fill-in MS Word DOC
Infectious Waste Processing Facility Construction and Operating Permits
Forms may be obtained by calling the Solid Waste Management Program at 573-751-5401.
- Application for Solid Waste Disposal Area or Processing Facility Construction Permit, Form--MO 780-0393 (09/96) PDF
- Demolition Landfill Solid Waste Tonnage Fee Report, Form--MO 780-1368 (11/08) Adobe PDF / Fill-in MS Word DOC
- Infectious Waste Processing Facility Fee Report, Form--MO 780-1905 (11/08) Adobe PDF / Fill-in MS Word DOC
- Non-Profit Scrap Tire Cleanup and Disposal Application, Form--MO 780-1997 (07/08) Adobe PDF / Fill-in MS Word DOC
- Non-Profit Scrap Tire Cleanup and Disposal Invoice, Form--MO 780-1998 (07/08) Adobe PDF / Fill-in MS Word DOC
- Officer/Management Employee Summary Sheet, Form--MO 780-1042 (10/00) PDF
- Sanitary Landfill Solid Waste Tonnage Fee Report, Form--MO 780-1367 (11/08) Adobe PDF / Fill-in MS Word DOC
- Table 1 - Cover Systems Construction and Repair Costs, Form--MO 780-1879 (04/04) PDF
- Transfer Station Solid Waste Tonnage Fee Report, Form--MO 780-1369 (11/08) Adobe PDF / Fill-in MS Word DOC
- Violation History Disclosure Statement and Summary Sheet, Form--MO 780-1250 (10/00) PDF
Solid Waste Disposal Area Construction Permit
Solid Waste Disposal Area Operating Permit
Forms may be obtained by calling the Solid Waste Management Program at 573-751-5401.
Solid Waste Management Districts
- 2008 Assessment Inventory District–Wide Survey Form, Form--MO 780-2003 (09/08) Adobe PDF / Fill-in MS Word DOC
- 2008 Assessment Inventory Form 1.1 - 1.2 Solid Waste Collection, Form--MO 780-2004 (09/08) Adobe PDF / Fill-in MS Word DOC
- 2008 Assessment Inventory Form 2.1 - 2.2 Recycling Collection, Form--MO 780-2005 (10/08) Adobe PDF / Fill-in MS Word DOC
- 2008 Assessment Inventory Form 3.1 - 3.2 Yard Waste Collection, Form--MO 780-2006 (09/08) Adobe PDF / Fill-in MS Word DOC
- 2008 Assessment Inventory Form 4. Services for Banned Items, Form--MO 780-2007 (09/08) Adobe PDF / Fill-in MS Word DOC
- District Grant Application Form, Form--MO 780-1990 and Instructions (05/08) Adobe PDF / Fill-in MS Word DOC
- District Grant Subgrantee Profile and Plan Implementation Form, Form--M0 780-1991 and Instructions (05/08) Adobe PDF / Fill-in MS Word DOC
- Fiscal Year District Operation Grant Profile and Budget Form, form--MO 780-1992 and Instructions (05/08) Adobe PDF / Fill-in Word DOC
- Solid Waste Management District Annual Report, Form--MO 780-1989 and Instructions (05/08)
Adobe PDF / Fill-in MS Word DOC - Solid Waste District Status Report, Form--MO 780-1993 and Instructions (05/08) Adobe PDF / Fill-in MS Word DOC
Solid Waste Processing Facility Construction Permit
Solid Waste Processing Facility Operating Permit
Forms may be obtained by calling the Solid Waste Management Program at 573-751-5401.
- Special Waste Disposal Request Form--MO 780-1166 (04/99) PDF
Waste Tire End-User Registration
- Scrap Tire End-User Registration Form--MO 780-1594 (11/08) Adobe PDF / Fill-in MS Word DOC
- Scrap Tire Material Grant Application, Form--MO 780-2008 and Instructions (11/08) Adobe PDF / Fill-in MS Word DOC
- Scrap Tire Monthly Summary Tracking Form - Collection Center--MO 780-1596 (11/08) Adobe PDF / Fill-in MS Word DOC
- Scrap Tire Tracking Form--MO 780-1593 (11/08) Adobe PDF / Fill-in MS Word DOC
- Scrap Tire Monthly Summary Tracking Form - Hauler--MO 780-1595 (11/08) Adobe PDF / Fill-in MS Word DOC
Waste Tire Hauler Permit
Forms may be obtained by calling Missouri Department of Transportation's Motor Carrier Services Unit at 573-751-3358.
Waste Tire Processing Facility Permit
- Application for Waste Tire Processing Facility Permit--MO 780-1597 (04/97) FILL-IN PDF
Water Pollution
- General Information on Water Pollution permits and Public Notices
- Issued Site Specific Permits
- Antidegradation Review Summary Attachment A: Tier 2 - Significant Degradation, Form--MO 780-2021 (01/09) Adobe PDF / Fill-in MS Word DOC
- Antidegradation Review Summary Attachment B: Tier 2 - Minimal Degradation, Form--MO 780-2022 (01/09) Adobe PDF / Fill-in MS Word DOC
- Antidegradation Review Summary Attachment C: Tier 2 - Temporary Degradation, Form--MO 780-2023 (01/09) Adobe PDF / Fill-in MS Word DOC
- Antidegradation Review Summary Attachment D: Tier 1 Review, Form--MO 780-2024 (01/09) Adobe PDF / Fill-in MS Word DOC
- Antidegradation Review Summary Tier Determination and Effluent Limit Summary, Form--MO 780-2025 (01/09) Adobe PDF / Fill-in MS Word DOC
- Application for Nonpoint Source Implementation Grants, Form--MO 780-1896 (02/06) Adobe PDF / Fill-in MS Word DOC
- Application for Nonpoint Source Pollution Minigrant, Form--MO 780-1947 and Instructions (12/07) Adobe PDF / Fill-in MS Word DOC
- Application for Sales Tax Exemption, Pollution Control, Form 318--MO 860-1146 (07/01) PDF
- Application for Transfer of Operating Permit--MO 780-1517 (03/08) Adobe PDF / Fill-in MS Word DOC
- Fee Calculation Information, Form--MO 780-1349 (07/08) Adobe PDF / Fill-in MS Word DOC
- No Degradation Evaluation Conclusion of Antidegradation Review, Form--MO 780-2026 (01/09) Adobe PDF / Fill-in MS Word DOC
- Permit Fees, State Operating Permits (11/00) PDF
- Permit Requirements for Underground Injection Control (UIC) Wells, Technical Bulletin--PUB221 (07/06) PDF
- Variance Application - 644.061 RSMo 1986, Form MO 780-0181 (06/04) PDF
- Water Quality Review Assistance (WRQA) Request, Form--MO 780-1893 (01/09) Adobe PDF / Fill-in MS Word DOC
- Water Pollution Control Permit Requirements for Mobile Wash Business, Fact Sheet--PUB244 (01/07) PDF
- Water Pollution Control Permit Requirements for Car Washes, Technical Bulletin--PUB247 (06/06) PDF
- Whole Effluent Toxicity (WET) Test Report Form--MO 780-1899 (07/08) Adobe PDF / Fill-in MS Word DOC
- Form UIC - Application for Class V Permit, MO 780-1826 (06/04) Adobe PDF / Fill-in MS Word DOC
- Discharge Monitoring Certification for Agrichemical Facilities Under General Permit MO-R24000, Form--MO 780-1723 (06/04) PDF
- Discharge Monitoring Report for Agrichemical Facilities Under General Permit MO-R240000 (Fertilizer Containment), Form--MO 780-1605 (05/02) PDF
- Discharge Monitoring Report for Agrichemical Facilities Under General Permit MO-R240000 (Pesticide Containment), Form--MO 780-1604 (05/02) PDF
- Form A - Application for Construction or Operating Permit, Form--MO 780-1479 (07/08) Adobe PDF / Fill-in MS Word DOC
- Form E - Application for General Permit, Form--MO 780-0795 (03/05) Adobe PDF / Fill-in MS Word DOC
Car Wash - refer to General Permits section
Concentrated Animal Feeding Operation (CAFO) Construction and Operating Permits National Pollutant Discharge Elimination System (NPDES)
- CAFO Annual Report, Form--MO 780-1953 (10/06) PDF
- CAFO Best Management Practices (03/06) PDF
- CAFO Plant Available Nitrogen Procedure (03/06) PDF
- Form F - Application for Approval or Permit for Concentrated Animal Feeding Operation--MO 780-0725 (06/04) PDF
Construction (Water Pollution)
- Form A - Application for Construction or Operating Permit, Form--MO 780-1479 (01/09) Adobe PDF / Fill-in MS Word DOC
- Form B - Application for Construction or Operating Permit for Facilities which receive basically Domestic Waste, Form--MO 780-1512 (09/08) Adobe PDF / Fill-in MS Word
- Form B2 - Application for Construction or Operating Permit for Facilities which receive basically domestic waste and have a design flow more than 100,000 gallons per day, Form--MO 780-1805 (10/08) Adobe PDF / Fill-in MS Word DOC
- Form I - Permit Application for Construction and Operation of Wastewater Irrigation Systems, Form--MO 780-1686 (06/04) Adobe PDF / Fill-in MS Word DOC
- Sewer Extension Construction Approval Request, Form--MO 780-1353 (07/04) PDF
- Application for Construction Permit - Sewer Extension, Form--MO 780-1632 (06/04) Adobe PDF / E-form
- Form A - Application for Construction or Operating Permit, Form--MO 780-1479 (07/08) Adobe PDF / Fill-in MS Word DOC
- Form B - Application for Construction or Operating Permit for Facilities which receive basically Domestic Waste, Form--MO 780-1512 (09/08) Adobe PDF / Fill-in MS Word
- Form B2 - Application for Construction or Operating Permit for Facilities which receive basically domestic waste and have a design flow more than 100,000 gallons per day, Form--MO 780-1805 (08/08) PDF
- Form C - Application for Discharge Permit - Manufacturing, Commercial, Mining and Silviculture Operations, Form--MO 780-1514 (06/04) PDF
- Form D - Application for Discharge Permit - Primary Industries, Form--MO 780-1516 (06/04) Adobe PDF / Fill-in MS Word DOC
- Form E - Application for General Permit, Form--MO 780-0795 (03/05) Adobe PDF / Fill-in MS Word DOC
- Form P - Notification of Hydrostatic Testing Under Permit By Rule, Form--MO 780-1874 (07/04) PDF
- Discharge Monitoring Report For Storm Water and Waste Water Discharges Under General Permit, Form--MO 780-1560 (07/04) PDF
- Monthly Monitoring Record for Wastewater Treatment Facilities, Form--MO 780-1306 (07/04) PDF
- NPDES Monitoring Report for Non-Municipal Wastewater Discharges, Form--MO 780-1307 (07/04) PDF
- Annual NPDES Operations Report for Non-Municipal Wastewater Discharges, Form--MO 780-1308 (07/04) PDF
General Permits
- Form E - Application for General Permit, Form--MO 780-0795 (03/05) Adobe PDF / Fill-in MS Word DOC
- Forms and general information regarding each type of permit listed below can be obtained by calling the Field Services Division's Regional Offices. Contact information and a map of the regional offices across the state is available online.
General Permits:
- Abandoned Mine Land Rec > 5 acres (G05)
- Ag/Wood/Food Compost Sites (G09)
- CAFO (G01) General information
- Car Wash (G75) Requirements PDF
- Clay Pits (G84)
- Dredging Lakes/River Harbor (G69)
- Feed Stock Compost Sites (G92)
- Fish Farms/Hatcheries (G13)
- Fuel Spill Cleanup (G94)
- Habitat Restoration Projects (G699)
- Heat Pumps (G251)
- Hydro Testing Non-Petroleum Related Pipelines and Storage Tanks (G685)
- Hydrostatic Testing Petroleum Related Pipelines and Tanks (G67)
- Limestone Quarries (G49)
- Oil/Water Separators (G14) General information PDF
- Petroleum Storage < 250,000 gallons (G35) General information
- Sand and Gravel Washing (G50)
- Swimming Pools Discharge (G76)
- Water Treatment Plant Settling Basins (ex. MO and MISS) (G64)
- Yard Waste Compost Sites (G97)
- Zeolite Softeners (G641)
No-Discharge General Permits - Land application of domestic wastewater biosolids 2000 or less
- Form E - Application for General Permit, Form--MO 780-0795 (03/05) Adobe PDF / Fill-in MS Word DOC
No-Discharge General Permits - Meat Slaughtering
- Form E - Application for General Permit, Form--MO 780-0795 (03/05) Adobe PDF / Fill-in MS Word DO
Heat Pump Permit - Must be in letterform to Department of Natural Resources Water Protection Program. Questions at 10 CSR 20-6.0702(B) must be answered in letter.
Land Application Permits (National Pollutant Discharge Elimination System NPDES)
Land Application of Industrial Wastewater Biosolids and Residuals
- Form R - Permit Application for Land Application of Industrial Wastewater Biosolids and Residuals--MO 780-1684 (06/04) Adobe PDF / Fill-in MS Word DOC
- Form I - Permit Application for Construction and Operation of Wastewater Irrigation Systems, Form--MO 780-1686 (06/04) Adobe PDF / Fill-in MS Word DOC
- Form A - Application for Construction or Operating Permit, Form--MO 780-1479 (07/08) Adobe PDF / Fill-in MS Word DOC
- Form B - Application for Construction or Operating Permit for Facilities which receive basically Domestic Waste, Form--MO 780-1512 (09/08) Adobe PDF / Fill-in MS Word DOC
Land Disturbance - refer to storm water section
Operating Permit - National Pollutant Discharge Elimination System (NPDES)
- Form A - Application for Construction or Operating Permit, Form--MO 780-1479 (07/08) Adobe PDF / Fill-in MS Word DOC
- Form B - Application for Construction or Operating Permit for Facilities which receive basically Domestic Waste, Form--MO 780-1512 (09/08) Adobe PDF / Fill-in MS Word
- Form C - Application for Discharge Permit - Manufacturing, Commercial, Mining and Silviculture Operations, Form--MO 780-1514 (06/04) PDF
- Form D - Application for Discharge Permit - Primary Industries, Form--MO 780-1516 (06/04) Adobe PDF / Fill-in MS Word DOC
Sewer Extension or Sewage Treatment Plant Construction Permit
- Form B - Application for Construction or Operating Permit for Facilities which receive basically Domestic Waste, Form--MO 780-1512 (09/08) Adobe PDF / Fill-in MS Word DOC
- Form S - Section 1. Domestic Sludge Reporting, Form--MO 780-1636 (06/04) Fill-in Adobe PDF / Fill-in MS Word DOC
- Form S - Section 2. Laboratory Results - Form SA and Form SB--MO 780-1630 (06/04) Fill-in Adobe PDF / Fill-in MS Word DOC
- Form S - Section 3. Land Application, Form--MO 780-1629 (06/04) Fill-in
Adobe PDF / Fill-in
MS Word DOC
Form SC - Land Application of Biosolids with Low Metals Concentrations
Form SD - Cumulative Metal Loadings for Land Application of Biosolids - Form S - Section 4. Sludge Hauling, Form--MO 780-1635 (06/04) Fill-in Adobe PDF / Fill-in MS Word DOC
- Form S - Section 5. Sludge Disposal Lagoon, Form--MO 780-1634 (06/04) Fill-in Adobe PDF / Fill-in MS Word DOC
- Form S - Section 6. Sludge Incineration, Form--MO 780-1633 (06/04) Fill-in Adobe PDF / Fill-in MS Word DOC
- Form E - Application for General Permit, Form--MO 780-0795 (03/05) Adobe PDF / Fill-in MS Word DOC
- Form G - Application for Storm Water Permit (Form E Must Be Included), Under the General Permit: Land Disturbance, Form--MO 780-1408 (05/07) Adobe PDF / Fill-in MS Word DOC
- Form K - Application for Individual Small MS4 General Permit, Form--MO 780-1802 (06/04) Adobe PDF / Fill-in MS Word DOC
- Form L - Application for Co-permittee Small MS4 General Permit, Form--MO
780-1801 (06/04) Adobe
PDF / Fill-in
MS Word DOC
Note: Form M must also be submitted - Form M - Application For Storm Water Permit (Form K or L must be included) Under The General Permit: Small Municipal Separate Storm Sewer System (MS4), Form--MO 780-1800 (05/07) Adobe PDF / Fill-in MS Word DOC
- Form O - Application for Land Disturbance Less than 5 Acres, Form--MO 780-1829 (06/04) Adobe PDF / E-form
- Stormwater Annual Report - MS4s, Form--MO 780-1846 (01/04) PDF
- Storm Water Permit Requirements for Lubricant Manufacturing, Fact Sheet--PUB230 (01/07) PDF
- Storm Water Permit Requirements for Oil/Water Separators, Technical Bulletin--PUB234 (06/06) PDF
- Forms and general information regarding each type of permit listed below can be obtained by calling the Field Services Division's Regional Offices. Contact information and a map of the regional offices across the state is available online.
Storm Water General Permits:
- Agrichemical Facilities SIC 5191 - MOR24
- Airports - MOR80F
- Chemical Mfg. - MOR23A PDF
- Fabrication Metal, Light Industrial/Structural/Foundries - MOR203 PDF
- Food and Kindred Products - MOR12A
- Land Disturbance >1 acres - MOR101-R108 PDF
- Land Disturbance by City, County or Other Government Entity - MOR100 PDF
- Land Disturbance in Designated areas - MOR109 PDF
- Lumber and Wood Primary - MOR22A
- Lumber and Wood Secondary - MOR22C
- Motor Freight/Passenger/U.S. Postal Transportation - MOR80C PDF
- Motor Vehicle Salvage - MOR60A PDF
- Paper and Allied Products - MOR14A PDF
- Plastics and Rubber Mfg. - MOR23D PDF
- Railroad Transportation - MOR80R
- Small Municipal Separate Storm Sewer System - MOR004
- Soil Remediation - MOR409 PDF
- Solid Waste Transfer - MOR80H PDF
- Textile and Apparel Products/Printing and Publishing Operations - MOR13
- Water Transportation - MOR80E PDF
- Wood Treaters - MOR22B
Swimming Pools Discharge - refer to General Permits section
- Form H - Request for Termination of a General Permit, Form--MO 780-1409 (03/05) Adobe PDF / Fill-in MS Word DOC
- Form J - Request for Termination of a State Operating Permit, Form--MO 780-1576 (03/05) Adobe PDF / Fill-in MS Word DOC
Underground Injection Control Permit (refer to publication Underground Injection Control (UIC) Wells PDF)
- Form UIC - Application for Class V Permit, MO 780-1826 (06/04) Adobe PDF / Fill-in MS Word DOC
Wetland or Dredge and Fill Approval - must contact the Department of Natural Resources Water Protection Program and ask for a 401 certification
Yard Waste Compost Sites - refer to General Permit section
Zeolite Softeners - refer to General Permit section
Water Wells
Well Certification and Registration
- Abandonment Registration Record, Form--MO 780-1603 (09/08) Adobe PDF / Fill-in MS Word DOC
- Casing Depth Request, Form--MO 780-1426 (04/03) Adobe PDF / Fill-in MS Word DOC
- Closed Loop Heat Pump Certification Record, Form--MO 780-1413 (07/97) Adobe PDF / Fill-in MS Word DOC
- Contractor Permit Application, Form--MO 780-1731 (08/07) Adobe PDF / Fill-in MS Word DOC
- Domestic/Multifamily Well Record and Pump Information Data, Form--MO 780-1902 (10/06) Adobe PDF / Fill-in MS Word DOC
- Experience Voucher, Form--MO 780-1423 (01/97) Adobe PDF / Fill-in MS Word DOC
- High Yield and Public Well Record and Pump Information Data, Form--MO 780-1901 (10/06) Adobe PDF / Fill-in MS Word DOC
- Investigation Request, Form--MO 780-1618 (04/02) Adobe PDF / Fill-in MS Word DOC
- Monitoring Well Certification Record, Form--MO 780-1415 (01/09) Adobe PDF / Fill-in MS Word DOC
- Public Water Supply Notification, Form--MO 780-1427 (10/04) Adobe PDF / Fill-in MS Word DOC
- Pump Information Record, Form--MO 780-1900 (05/05) Adobe PDF / Fill-in MS Word DOC
- Reconstruction Registration Record, Form--MO 780-1414 (04/02) Adobe PDF / Fill-in MS Word DOC
- Testing Application, Form--MO 780-1424 (11/06) Adobe PDF / Fill-in MS Word DOC
- Variance Request, Form--MO 780-1422 (04/03) Adobe PDF / Fill-in MS Word DOC
- Vehicle Application, Form--MO 780-1425 (03/02) Adobe PDF / Fill-in MS Word DOC
Fill-in Forms
Working with PDF Fill-In Files
We are providing PDF fill-in documents for some MoDNR forms. This will allow you to enter information directly from your PC and print the form with the information entered. However, there is no computation, validation or verification of the information you enter, and you are still responsible for entering all required information. Instructions may require some information to be handwritten on the form. Forms for which this option is available have the words "Fill-in PDF" after the name of the form.
If you want, you may save PDF FILLABLE FORM files to your hard drive using the following steps. However, the data you enter into the fill-fields can be saved only if you have the entire Adobe Acrobat software package.
- Right click on the active link to the form.
- Access the "Save Target As" option in the drop-down menu.
- Save the file to the location of your choice, e.g., Desktop or C Drive.
- Double click on the file and the Adobe Reader 4.0 will open the form.
- Fill in the form and print out when complete. (If you have the entire Adobe Acrobat software package, entered data can be saved for later use and editing.)
To use the fill-in forms:
- Open the PDF form.
- Select the hand tool from the Acrobat toolbar menu.
- Move the hand pointer inside a form field. Click when it changes to an I-beam pointer.
- The I-beam pointer allows you to type text.
- The arrow pointer allows you to select a field or check a box.
- Press Tab to accept the information you have typed and go to the next field.
- Press Shift + Tab to accept the information you have typed and go to the previous field.
- You may also use your mouse to move from field to field.
Note: You cannot access the check boxes using the Tab key. You must click on the check-box fields with the arrow pointer.
When you have completed the form, print as usual.