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Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an
<br />average per response for some minor facilities, to l 10 hours as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of 1 S hours per response, including time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />'completing and reviewing the collection of information, including suggestion for reducing this burden, to
<br />Chief, Information Poticy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />Washington, DC 20460; and to the Office of Information and Regulatory Affavs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If farm has been partially completed by preprinting, disregard instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Fermittee Name/M~i[ing Address (and facility name/location, if different)," "Permit Number," and "Cischarge
<br />Number" where indicated. (A separate form is required for each discharge.)
<br />3. Eater dates beginning and editing "Monitoring Period" covered by form where indicated.
<br />4. Enter eacL "Paramzter" as specified in monitoring requirements of permit.
<br />5. Enter "Sampla Me~surzm~nt"data for each parameter under "Qreantity"and Quality"as specified is permit. 'Avzrvbe" is
<br />normally arithmetic average (geometric average for bacterial parameters) of all sample measurements For each pe,z netcr
<br />obtained during "Nlc,;iloring Period"; ".;/r:iumm" and lAinimwu" are normally e;areme high anc; low measwaml:nu
<br />obtained during ".~;-.~rit~.,~iuti Fericl". Q~otc to mli.icioals ~• i:b secondary treatcznt r uiremcnt: Entc• 30-day a~-c age
<br />Of SamplC mCaSL iCmCi~tS under "A!'s1".~oz," and CntCr ma3CLT LlIn 7-d_y aVCI2gC Of 5"Tn7!Z mCa~7lrCmCntS Oi~tamed do lnl;
<br />monitoring period under "iraximum.")
<br />v. Enter"Pe;-mitPlzgrirrr,re,ir"Coreacipanrrretcran~.,-"i;raor'itJ-"and"Qvali,~"as~pecificd inrenn~t.
<br />7. Under "TIo liz" . _, number of sample m.;asuremcn: ,laming mo~~~tn~i~~ ,l~riod t st .: ;coed ma;;imw~ (cnd/cr Irli: ~,~u;n
<br />or 7-c'ay acer~c zs . ppropriate) ,.c~ ni[ regal cement for each parameter. if nose, enter "0".
<br />8. ~n:er "Fn;rrcusy ,j An_~lps%s"hot%~ as "S'.-; /~ ?; ~=sr~,~„ts,rt" (ectsl f.:qu~rcy c"sanpling ant. ~ ,a!ysis sod dv~in„
<br />n:On:iORn~, pET.Od) find a5 ':°~.-,,:it Re.; uir~,rr~a!" spcci (;cd in per7ni+.. (e.g. l;ntc~ "Cc,rl, "for coal ^ueus rren•:onng, "1/7"
<br />5:, one day per ~rec'ti "1/30" for cne day rer month, "1/90" for one day per quarter, crc.)
<br />9. inter "Sar,rpla TjF~" belt as "S~rn~,le ~~~ _ur.~er,u~rr" (zen al sample l;ape used Cur~~:g monitoring ne-iu) anc: as "F,,;,tir
<br />Reyuirem_.r," (eg. Winter "ir•aP" fcr i.rdividuaf sanple, "14i!~" for 24hour composite, ",'1/,i" Cur cor~'.'~r~ous
<br />monitoring, etc.)
<br />10. \'there violatious ofpe-~nit roquircrnents an re;,orted, attach abriefezplanatinn to dcscrbc cause rnd co~~ecfive c.'`.~rs
<br />to be taken, and reference each violation by crate.
<br />11. if "no discharge" occurs d;:rht~ mo;,aon,ig period, e~~tr.r'T:o Bischarge" across Form in place of data entry.
<br />]2, linter "Name/Title of Principal Es:•~utive C~~er" with "Sie•rranrre of Prin~ipa! it.re.z•tiv~ r~_-zr , j .ie•-5•.r-:~ a
<br />Agent, ""Telzp/nnz Nu,nber, "and "Date" at bottom of form.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your rocords.
<br />14. More detailed instmctions for use of this Discharge Monitoring Rzp,r4 (DMI~ form may be obtained from Grace(s)
<br />specified in permit.
<br />legal Notice
<br />Phis report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to repoR or failure to report truthfully can result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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