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Reduction Act
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as m
<br />average per response for some minor facilities, to 110 hours as an average per response for some major facilities,
<br />v{ith 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 />reviewiog the collection of information. Send comments regarding the burden estimate or any other aspect of
<br />this collection of information, including suggestions for reducing this burden, to Chief, Information Policy
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; end to the
<br />Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
<br />General Instructions
<br />li.:If form has been partially
<br />ready preprinted.
<br />completed by preprinting, disregazd instructions directed at entry of that information
<br />2. Enter 'Permittee Name/Mailing Address (and facility namellocatign, if differenQ," "Permit. Humber," and
<br />="Discharge Number" where indicated. (A separate forth is required for each discharge.)
<br />~; 3.,Enter dates beginning and ending 'Monitoring Period,." covered by form where indicated.
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<br />E ` 4.-Ekttei each "Parameter" as specified in monitoring requirements otpermit.
<br />-5. `Ente'r "Sample Measurement" data for each parameter under "Quantity" and "Quality" in units specified in permit.
<br />i• ~ "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements
<br />Sor each parameter obtained during "Monitoring Period'; "Maximum" and "Minimum" are normally extreme high
<br />1 and,'ow measurements obtained during "Monitoring Period." (Note to municipals with secondary treatment
<br />I; rCquirement: Enter 30day average of sample measurements under "Average," and'enter maximum 7~ay average
<br />of samplgmeasurements obtained during monitoring period under'SLfaximum. J
<br />;8. Enter "Permit Requirement" for each parameter under "QI(antity" and "Quality" as specked in permit.
<br />7.dUndfr "No Fx" enter number of sample measurments during monitoring period that exceed maximum (and/or
<br />;men/mum or 7-day average as appropriate) permit requitement Cor each parameter. If none, enter "0".
<br />f:-$. Enter "Frequency ojAnalysis" both as "S'ample Afeusultinent" (actual frequency of sampling and analysis used
<br />E ; 'durin`g monitoring period) and as "Permit Requirement" specified in permit. (e.g., Enter "Coat," for rnntinuous
<br />motdtoring, "1/7" for one day per week, "1/30" for oneday per month, "I/90" for one day per quarter, etc.)
<br />:. ...
<br />nee{ "Sample Type" both as "Sample Measurement"gactual sample type used during monitoring period) and as
<br />Permit Requirement," (e.g., Enter "Grab" for individeal sample, l4HC' for 24-hour composite, "N/A" (or
<br />' continuous monitoring, etc.)
<br />~Q' Where violations of permit requirements are reported;:a(tach a brief explanation to describe cause and corrective
<br />Y'; fictions taken, and reference each violation by date.
<br />R.3 L
<br />X41. -(f "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
<br />~,~Enter "Name/title ojPrincipal Executive Officer" with "Signature ojPrinctpn! Executive Officer ojAuthorized
<br />t«P. 'Agent," "Telephone Number," and "Date" at bollotp of form.
<br />~~, Mail signed Report to Office(s) by date(s) specified in pern»t. Retain copy for your records.
<br />I ~.
<br />More detailed instmctions for use of this Discharge Monitoring Reporl(DMRJ form may be obtained from Office(s)
<br />specked igpermit.
<br />g.
<br />`a; : Legal Notice
<br />Y.'
<br />~• .,
<br />r+~port 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 />to civil penalties no[ to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />0 olation, or by imprisonment for not more than one year, or by both.
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<br />E ,Form 3320-1 (Rev. 08-95)
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