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Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of int-ormatioo is estimated to very from a Lange of 10 hours as an
<br />average par response for some minor facilities, to 1 ] 0 hours as en average per response for some major facilities,
<br />with a weighted average for major and minor facilities of IB hours per response, including time for reviewing
<br />instructions, searching existing data sources, gathering and maintaining [he data needed, and completing and
<br />reviewing the collection of information. Send wmmenls regarding the burden estimate or any other asput at
<br />this collection of information, including suggestions for reducing this burden, [o Chief, information Policy
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SN/ Washington, DC 20460; and to the
<br />Office of information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially completed by preprinting, disregard instructions directed at entry of that information
<br />already preprinted.
<br />2. Enter 'Permittee ,'v'ame~;tlaifing Address (and facility nameAocation, if diflerenQ," "Permit Number," and
<br />"Discharge A'umber" where indicated. (A separate form is required far each discharge.)
<br />3. Enter dates beginning and ending 'ilfonitoring Period" covered by form where indicated.
<br />4. Enter each "Poranrerer" as specified in monitoring requirements of permit.
<br />5. Enter ".S'ample Afeosuremenr" data for each pat'amcler under "Quonary" and "Qunhty" in units specified in pertmt.
<br />"Average" is normally arithmetic average (gwmetric average for bacterial parameter) of all sample measurements
<br />for each parameter obtained during';lfonituring Period', "Afazimunr" and ",tfinimum" arc normally extreme high,
<br />and low mcasuremems obtained during "Afu~irunng Period." (Mole fo municipals Stith secondary treatment
<br />requirement Enter 3n-da}' average of sample meanucments under "Average," and enter ma.~imum 7-day avuage
<br />of sample measurements obtained during monitaring period under ",14arimwn.
<br />6. Enter "Permit Reyuirernent" for each parameter under "Qumrrity" and "Quality" a< specified m pernu[.
<br />7. Under "Nu Fs" enter number of sample measurments during monitoring period that exceed maximum (and/or
<br />minimum or 7-day average as appropriate) permit requirement for each parameter. If none, enter "0".
<br />6. Enter "Frerryency oj:tnalysis" both as ".Sample .tleasurment" (actual frequency of sampling and analysis used
<br />during monitoring period) and as "Pennir ReyviremrenP' specified in permit. (e.g., Enter "Corr," Cor continuous
<br />monitoring, "1/T' for one day per week, "l-30" for one day per month "IiSO" for one day per quarter, etc.)
<br />9. Enter "Sample Type" both as "Sample Aleasuremenl" (actual sample type used during monitoring period) and as
<br />"Permit Kequiremen(," (e.g., Enter "Grab" fx individual sample, "24HC"' for 24-hour composite, "1'Ub'"' for
<br />continuous monitoring, etc.)
<br />10. Where violations of permit requirements are r~:ported, attach a brief explanation to describe quse and corrective
<br />actions taken, and reference each violation by dtte.
<br />11. If "no discharge" occurs during monitoring peri~~d, enter "No Discharge" across form in place of data entry.
<br />12. Enter ",Norne/1'itle ojPrincipa! Executive Officer" vvith "Signature ojPrincipal Executive Officer ojAulhorized
<br />Agent," "Telephone t•Jumber," and "Date" at bottom of form.
<br />13. Mail signed Report to OBice(s) by date(s) specified in permit. Retain rnpy for }rout records.
<br />l4. More detailed instructions for use of this Discharge tifonitoring Report (DtifR) form may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />7Lis report is required by law (33 U.S.C. 1318; 40 C.F.R. 175.27). Failure to report or failure to report truthfully can
<br />result in civil penalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525.000 per day
<br />of violation, or by imprisonment for not more than one: year, or by both.
<br />EPA Form 3320-1 (Rev. OS-95)
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