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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as as average per response for some minor facilities, to 110 hours as an average per response for some major facilities, ~ with a weighted average for major and minor facilities of 18 hours per response, including time For reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. General Instructions 1. if fot~a has been partially completed by preprinting, disregard instructions directed a[ entry of that information already preprinted. 2. Enter "Permittee Name :11alling Address (and facility nameJloca[ion, if different)," "Permit ,Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'ilfoniroring Period" covered by form where indicated. 4. Enter each "f'ararrreter" as specified in monitoring requirements oC permit. 5. Emer "Sample ,tlracurenrenr" data for each parameter under "Quonrity" and "Quality" in units specified in permit. ".average" is normally arithmetic average (grnmetric average for bacterial parameters) of all sample measurements for each parameter obtained during ".tfonitori.hg Period'; ",tfurimum" and ",Lfinimum" arc normally extreme high and low measurements obtained during ".1Acniroring Period." (Note to municipals with secondary treatment requirement Enter 30-day average of sample mensuremcnis under "Average," and enter maximum 7-day aremge of sample me.•tsurcments obtained during monitoring period under "klazirnurn. ") 6. Enter "Perm:r Reyvircmenr" for each parameter under "Quanriry" and "Quality" as specified in permit. 7. Under "h'o Fes" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) permit requirement for each parameter. U none, enter "0". 8. Enter "Frequency uj.4nnlysis" both as ".Sample .Lleasvrmenr" (actual frequency of sampling and analysis used during monitoring period) and as "Pernrir Rerruir•etrreur" specified in permit. (c.g., Enter "Copt," for continuous monitoring, ")~7" for one day per week, "1'30"~for one day per monOt. "1/p D" for one day per quarter, etc.) 9. Enter "Sample Tvpe" both as "Sample .LfeusuremenP' (actual sample type usctl during monitoring period) astd as "Permit Requirement," (e.g., Enter "crab" for individual sample, "2•iNC" for 21-hour composite, "N/A" for conlinubus monitoring, etc.) 10. Where violations oC permit requirements are sported, attach a brief explanation to describe cause and corrective actions )alcen, and reference each violation by d;ne. 11. if "no d~scharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter ".iVame/Pitle of Prinapal Executive Officer" wilt "Signature of Principal Executive Officer oJAuthorized Agent," ~"Telephone Number," and "Dare" at bottom of form. 13. Mail signed Report to Offce(s) b}' date(s) specified in permit. Retain copy Cor your records. 14. More detailed instructions for use of this Discharge dfomroring Report (DtifR) forts may be obtained Cram Office(s) specified in permit. Legal Notice Ibis 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 result in civil penalties not to exceed f 10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day of violation, or by imprisonment for not more than ane year, or by both. EPA Form 3320-1 (Rev. OS-95)