Annual Water Use Reporting Form For Non-Irrigators

Part 1 of 2

Authority

Collection of major water use data by the DNR is required under a law passed in 1983 by the Missouri General Assembly (RSMo Chapter 256.400, 256.405, 256.410, 256.415, 256.420, 256.425, and 256.430).

Instructions

Annual water use reporting shall be completed by March 31 for the previous calendar year.
Water use registration is required if a facility’s total combined withdrawl capacity is greater than 100,000 gallons per day, regardless of actual water withdrawal amount. This is equivalent to 70 gallons per minute.
If you have new wells or new surface water diversions, please report that information to us on Part 2 of the Annual Water Use Reporting Form.
Annual reports must be submitted even if no withdrawals were made.

Note: You may only report annual water use data for four withdrawal points on this online reporting form. If you have more than four withdrawal points, you may submit multiple times, however we recommend that you send us your annual water use data via U.S. Mail, fax or email.

Required Fields (*)

Reporting Year

Contact Information

Operator or Facility Information

Company/Contact Name: *

Address 1: * Address 2:

City: * State: * Zip: *

Telephone: * E-mail:

Municipality or Owner Information

Company/Contact Name: *

Address 1: * Address 2:

City: * State: * Zip: *

Telephone: * E-mail:

Facility Information

Major Water User ID No. (Leave blank if first time reporting.)

What months did water withdrawal or diversion take place?
All Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Approximately how many days was water withdrawn or diverted last year?

How many gallons of water is withdrawn or diverted on an average day of operation?

When did withdrawal or diversion originally begin (mm/yyyy)? (This will help establish historical use.)

Water Use Data for All Non-Irrigators

If you are a municipal water user, you may report 100 percent municipal water use, or you may split your municipal water into multiple categories.
It is very important to report your water use accurately. If you are uncertain of the category that best suits your water uses, please feel free to contact us.

Category	Definition	Percent of Total
Municipal	Water withdrawn by public and private water suppliers for a variety of uses including domestic, commercial, industrial, and public use *	%
Commercial	Water used for hotels, restaurants, office buildings or institutions.	%
Domestic	Water withdrawn for household purposes and watering lawns and gardens.	%
Fish and Wildlife	Water used for fish and wildlife habitat including aquaculture.	%
Livestock	Water for livestock watering, feedlots, dairy operations and other farm needs.	%
Electrical	Water withdrawn or used in the process of generating electricity including nuclear, hydropower, thermoelectric and pumped storage operations.	%
Industrial	Water withdrawn or used for industrial purposes such as refining, smelting, fabrication, processing, washing and cooling.	%
Mines and Quarries	Water withdrawn for the extraction of minerals or dewatering for quarrying. This does not include processing such as smelting, refining or slurry pipeline operations.	%
Drainage and Dewatering	The removal of water through draining or pumping to lower the water table.	%
Other	Please explain	%
*Public water use is water provided by a public supply for such uses as firefighting, street washing, water treatment, municipal buildings, parks and swimming pools.		100 % Total

Part 2 of 2

This data must be completed for all new withdrawal points. Previously reported data is also available online at /env/wrc/mwudata.htm. Please review your previously reported data for accuracy and make changes if necessary. At the bottom of this form there is a comment box to submit additional information or changes. Please specify which well or withdrawal point you are reporting water use for. It is not necessary to resubmit other general well or pump data if it is correct.
If you have never submitted a water use inventory form or if you have added new withdrawal points, a map showing the location of each point is required. Plat maps showing the legal description are preferred. We can provide a map upon your request. Please be sure to label each point.
Assistance is available upon request for water use estimating.

Mines and Quarries (Entities that pump water from mines and quarries shall only be required to set forth the quantity pumped from the mine and quarry at each point where it is pumped to the point to discharge, and only the name of the stream into which any of the discharge is permitted to flow.)
Diversion Point No.
Quantity Pumped (gallons per year)
Discharge Point or Stream

Widthdrawl ID.
Owner Name
Other Information
Status
Well Data (Disregard this section if surface water)
Year Drilled
Well/Intake No.
Total Depth, ft.
Casing Depth, ft.
Static Water Level, ft.
Surface Water Data (Disregard this section if groundwater)
Water Body Type
Water Body Name
Pump Data
Pump Capacity, gpm
Metered (Y/N)	Yes No	Yes No	Yes No	Yes No
Location Data
Quarter Sections (Smallest 1st)	, ,	, ,	, ,	, ,
Legal Description	Sec Twp N Rng	Sec Twp N Rng	Sec Twp N Rng	Sec Twp N Rng
County
Latitude
Longitude
Elevation, ft.
Water Use Data
Water pumped, gal.
Additional Information
Please enter any additional information or comments