Mo 780 1560 Form PDF Details

In the vast and crucial universe of environmental conservation and water quality management, the MO 780 1560 form serves as a vital document for the Missouri Department of Natural Resources, specifically within the Water Protection Program's Water Pollution Branch. This form, designed as a Discharge Monitoring Report for stormwater and wastewater discharges under a general permit, plays a critical role in the regulatory process. It meticulously records various aspects of a facility's discharge over a defined period, starting from basic facility information, through to detailed monitoring data and analytical results of water samples. Facilities are required to report their name, location, permit number and then proceed to document the specifics of water sampling, including types of samples collected, the number of samples, and details about the laboratory analysis. Additionally, the form is structured to capture analytical results, such as outfall numbers, sample types, parameters measured, and the volume and content of discharged water. This allows for a comprehensive overview of the facility's environmental impact and compliance status. It is essential for maintaining a safe and healthy water system, demanding precision and integrity from reporting facilities. The instructions attached to the form guide users on how to report accurately, including what to do if no discharge occurred, indicating the profound importance of even non-events in environmental monitoring. The process of completing and submitting this form is carefully outlined, emphasizing accuracy, compliance, and the importance of environmental stewardship in Missouri.

QuestionAnswer
Form NameMo 780 1560 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesmissouri discharge monitoring report, missouri discharge storm latest, missouri discharge storm water, mo dmr form printable

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MISSOURI DEPARTMENT OF NATURAL RESOURCES

WATER PROTECTION PROGRAM - WATER POLLUTION BRANCH

DISCHARGE MONITORING REPORT FOR STORM WATER AND WASTE WATER DISCHARGES UNDER GENERAL PERMIT

THIS REPORT COVERS THE PERIOD FROM (MONTH/YEAR)

THROUGH (MONTH/YEAR)

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

/

 

PART I:

FACILITY INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FACILITY NAME

 

 

 

 

 

 

 

 

 

COUNTY

 

 

 

 

PERMIT #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MO-

 

PART II:

MONITORING INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLES COLLECTED BY

 

 

 

PHONE NUMBER

 

 

 

NUMBER OF SAMPLES

 

LABORATORY (NAME AND ADDRESS)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRM

 

 

 

 

 

 

 

 

 

 

ANALYSIS PERFORMED BY: PLEASE TYPE OR PRINT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART III: ANALYTICAL RESULTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OUTFALL #

001

 

 

002

 

003

 

 

 

 

 

SAMPLE

ANALYTICAL METHOD

DATE AND TIME OF

DATE

 

 

 

DATE

 

DATE

 

DATE

 

 

TYPE

 

SAMPLE COLLECTION

 

 

ANALYSIS

 

ANALYSIS

 

 

 

ANALYSIS

 

 

ANALYSIS

 

 

 

 

 

 

 

 

DATE

 

DATE

 

 

 

DATE

 

 

DATE

 

 

 

Parameter

 

Unit

TIME

 

TIME

TIME

TIME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rainfall Amount

in.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Flow

 

MGD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

pH

 

Units

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Settleable Solids

mL/L/hr

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Oil & Grease

mg/L

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other (list)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF INDIVIDUAL PREPARING REPORT (PLEASE TYPE OR PRINT)

 

 

 

 

 

 

FIRM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF INDIVIDUAL PREPARING REPORT

 

 

 

 

 

 

 

 

 

 

 

 

PHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORT APPROVED BY OWNER

 

 

 

 

 

 

 

PHONE NUMBER

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MO 780-1560 (7-04)

INSTRUCTIONS

Report should be typed or neatly printed.

PART I:

1. Fill in facility information and permit number.

PART II:

2.Give the name of the individual who actually collected the sample. Indicate whether samples were collected by owner or by personnel of the lab performing the analysis. Indicate the number of samples taken.

PART III:

3.Report results for those parameters listed in Part A of your permit. Write N.A. (Not Applicable) if your permit does not require one of the pre-printed parameters. List under “Other” any additional sampling results required by your permit.

If a storm water sample, indicate the amount of rainfall for the rainfall event in which the sample was taken and write the source of this data (e.g., rain gauge, weather data, etc.) under “Analytical Method” column. If not a storm water discharge, write N.A. in the “Rainfall Amount” column.

4.File a report even if no discharge occurred during the monitoring period. Complete the Facility Information section, write “ND” (no discharge) in the Flow column in Part III, and sign the report. NOTE: If a discharge of storm water occurs at any time during the monitoring period, it must be reported.

5.Record Sample Types as G, C, M or E. G = grab, C = composite, M = measured, and E = estimate. See permit for type of sample required for each parameter.

6.Narrative monitoring requirements for “chemicals stored outside”, “soluble bulk materials stored outside”, etc. are required only if specifically requested by the department in written form. If you have questions about these requirements, contact the Water Protection Program.

7.Add pages if reporting for additional outfalls or sampling dates is needed.

8.Report must be signed by owner and individual preparing the report. Please provide a phone number where each can be reached. Print the name of the individual who prepared the report.

9.Mail to the appropriate DNR regional office as noted in your permit cover letter.

Note: This form is a universal reporting form for General Permits for storm water and waste water discharges with a permit number begin- ning MO-R or MO-G. Industries and individuals who have report forms designed for their specific needs may substitute their forms. A suitable substitute must meet the following specifications:

(a)Form must be 81⁄2” by 11”.

(b)Report must show all of the information indicated on the standard form.

MO 780-1560 (7-04)

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