Source Water Protection Semi-Annual Status Report Form
This information is provided by the Nebraska Department of Environmental Quality  
to assist the public and regulated community .

Form #:  11-001
Grant Information
Revised: 1/1/11


Filling out the Source Water Protection Status Report:

Project: (Enter your project name)
Sponsor Name: (Enter name of community/organization who requested the grant)

Year: (current year)
Reporting Period: (select the period you’re reporting for)

The information in this report should address:
  • Any progress to date;
  • Significant findings or events;
  • Corrective actions taken to resolve any problems that may have been encountered; and
  • Activities planned for the next reporting period.

Refer to the Work Plan (Attachment A) that is attached to the Intergovernmental Agreement (contract).

Objectives: (Discuss how the work plan objectives have been addressed in this reporting period.)

Tasks: List each task as specified in the intergovernmental agreement (contract) work plan. Identify whether each of those tasks are “to be initiated”, “completed”, or “on-going.” For tasks that were completed in the reporting period or are considered on-going, please give a brief statement about the activities toward that task.

For additional information, contact the Source Water Protection coordinator at 402-471-6988