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The West and East Forks of the Grand rise just south of Creston in Union County, Iowa. The Middle Fork rises at Mount Ayr, Iowa in Ringgold County, Iowa. The three forks merge just south of Albany, Missouri in Gentry County, Missouri and that is where the river officially assumes the single Grand River name. The biggest confluence of streams is at Chillicothe where the Thompson River and Shoal, Medicine, and Locust creeks merge with the river. Trenton obtains their water supply from Thompson River. Thompson River stream gage at Trenton, drainage area 1670 square miles is located approximately one mile downstream of the pump intake.