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Reduction Act ,,. repoding burden for this collection of information is estimated to vary from a range of 10 hours as an e per response for some minor facilities, to 110 hours as an avenge per response for some major facilities, '1~igpled average for major and minor facilities of 18 hours per response, including time for reviewing ~aos~ searching existing data sources, gatherimg and maintaining the data needed, and completingand iqg the,c'ollectiom of information. Send comments regarding the burden estimate or any other aspect of dlection of information, including suggestions for reducing this burden, to Chief, Information Policy t;;PM-223, U.S. Environmemtal Protection Agency, 401 M Street, SW Washington, DC 20460; and to the of Information and Regulatory Affairs, Office of Management amd Budget, Washington, DC 20503. General Instructions ~1; ]f form has been partially completed by preprinting, disregard inswctions directed at entry of that information 1~_~~tltesdy preprinted. _ - 'Permiltee Name/,Llaiting Address (and facility name/location, if different)," "Permit Nrrrnber," and rrge Number" where indicated. (A separate Corm is required for each discharge.) dates beginning and ending "Monitoring Period" covered by form where indicated. t;. er each "Parameter" as specified in monitoring requirements of permit. inter "Sample Measurement" data for each parameter under "Quantity' and "Quality" in units specified in permit. "r"'Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements Sot each parameter obtained during "Afoniloring Period'; "Maximum" and "Afinimum" are normally extreme high and .low measurements obtained during ".4onitoring Period." (Note [o municipals with secondary Veatmegt (~ requirement: Enter 30-day average oC sample measureml'n[s under "Average," and enter maximum 7~day average ;_ ; of sample measurements obtained during monitoring ptdritld under "Maximum. ' 6. Enter "Permit Requirement" for each parameter under "Q$anrity" and "Quality" as specified in permit. 7::Uoder ",No Er" enter number of sample measurments during monitoring period that exceed maximum (and/or .'i minimum or 7-day average as appropriate) permit requirement for each parameter. If none, enter "Q". ~nter "Frequency ojAnalysis" both as "Sample Meusurrnent" (actual Frequenry of sampling and analysis used .during monitoring penod) and as "Permit Requirement" specified in permit. (e.g., Enter "Copt," for continuous monitoring, "//7" for one day per week, "1/JO" for one.day per month, "1/90" for one day per quarter, etc.) l .Enter "Sample Type" both as "Sample Measurement" (adual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" far ind}Vt~ual sample, "?4HC' for 24-hour composite; "N/A" for ,continuous monitoring, etc.) " ;Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective -fictions taken, and reference each violation by date. - If "no dischazge" occurs during monitoring period, enter "Na Discharge" across form in place of data entry. !. Enter "Name/title ojPrincipa/ Executive Officer" with "Signature ojPrincipa( Executive Officer of Authorized ~; 'Agent," "Telephone Number," and "Date" at bottom of form. Mail signed Report to O6ce(s) by date(s) specified in perntit. Retain rnpy for your records. E4: More detailed instructions for use of this Discharge Monitoring Report (DMR) form may be obtained from Office(s) "' specJed in permit. Legal Notice ort is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can civil penalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525,000 per day ion; or by imprisonment for not more than one year, or by both. 3320-1 (Rev. OH-95) .-