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Paperwork F.eduction Act Notice
<br />Public reporting burden for this collection of infirrtnation is estimated to vary from a range of ]0 hours as an
<br />average pet response for some minor facilities, to 1 IO hours as an average per response for some major facilities,
<br />with a weighted average for major and minor facilities of 18 hours per response, including time for reviewing
<br />instructions, searching existing data sources, gathering and maintaining the. data needed, and completing and
<br />reviewing We collation of information. Send comments regarding the burden estimate or any other especi of
<br />this wllection of information, including suggestions for reducing this burden, to Chief, Information Policy
<br />Branch, PM-223, U.S. Environmental Protection .4geacy, 401 M Street, SW Washington, DC 20460; and to the
<br />Office of Information and Regulatory Affairs, Office of Management and Budget, WrLShingtoa, DC 20503.
<br />General Instructions
<br />1. If form has been partially wmpleted by preprinting, disregard instructions directed at entry of that information
<br />already preprinted.
<br />2. Enter "Permittee A'ome%'Noiling Address (ard facility nameJlocation, if different)," "Permit Arumber," and
<br />"Discharge Number" where indicated. (A separate form is inquired for each discharge)
<br />3. Enter dates beginning and ending ",l foniroring Period" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in moaitor.ng requ~rcmcnts of permit.
<br />S. Enter "Smnple blcasrtremenP' data for cac t paruncter unde- "Quamity" and "Quality" in units spacilied m permit.
<br />"Average" is nomtaily arithme?ic avcrabe (geoructric average for bacterial parameters) of al! sample measr.remenLs
<br />for each pararrtetcr obtained due ng ",lfunrmring Pcric.P'; "alarirnurn" and 'Stlini num" are normally extreme high
<br />and low measurements obtained during ".tlo~itoring Prrud." (Note to municipals with secondary treatment
<br />rcquuemcnt Enter 30-dap avcmgc of sample measuremens under "Average," and enter maxmum 7~ay average
<br />of sample measurements obtained during monitoring pc,zod under ",lfaximu+n. l
<br />6. Enter "Permit Requirement" for each parameter under "Quantity" and "Qu~l+ry" as spt.~ificd in permit.
<br />7. Under "Na Er" enter number of sarnple measurments during monitoring period that exceed maximum (and/or
<br />minimum or 7-da}' avcmge as appropriate) peen tit requircmen[ for each pa amen. ]f none, enter "~7".
<br />B. Enter "Frequency oj:lnalysis" both as "Sample Sleosar+nent" (actual frequency of sampling and analysis used
<br />during monitoring period) and as "Pennir RenuiremenP' spcciLed in permit. (e.g., Enter "Conk" for continuous
<br />monitoring, "1~7" for one day per week, "/ X30" for one c'ay per month, "I X90" for one day per quarter, etc.)
<br />9. Enter "Sample Type" both as "Sample ,tfeasuremeru" (actual sample type used during monitoring period) rand as
<br />"Perrnie Requirement," (e.g., Enter "Grab" Ibr indi~.idual sample, "2a1fC" for 24-hour composite, "N/A" for
<br />continuous monitoring, etc.)
<br />10. Where violations oC permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />actions taken, and reference each violation by dale.
<br />11. L` "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
<br />12. Enter "Name.Title ojPrincipal Executive Officer" with "Signature ojPrincipnl Executive Officer ojAutharized
<br />Agent," "Telephone Number," and "Date" at bo4tom of form.
<br />13. Mail signed Report to Office(s) by date(s) specified in pcmrit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Afonitoring Report (DMR) form may be obtained from Office(s)
<br />specified in permit.
<br />', Legal Notice
<br />77tis report is~ required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can
<br />result is civil~oenalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />of violation, r by imprisonment for not more than one year, or by both.
<br />EPA Form 3320-1 (Itev. 08-95)
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