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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 an average per respotse for some minor facilities, to 110 hours u en 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,-gat!htiting and. maintaining the data needed, ant: completing and reviewing the collection of information. Seed corna~lS regarding the burden estimate or ray other zspect of this collection of information, including suggestions fet reducing this burden, to Chief, information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 2[)460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.', General Instructior>~s 1:• If form has been partially completed by preprinting, disregard instructions directed at entry of [hat information 9rtady Preprinted. - - 2.=::Enter 'Permittee Name/1l4ailing Address (and facility name/location, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required foreach discharge.) 3. Enter dates beginning and ending 'Monitoring Periad" covered by Corm where indicated. 4. Enter each "Parameter" as~specified in monitoring requirements of permit. 5. Enter "Sample Measurement" data for each parameter under "Quantity" and "Quality" in units specked in permit. "Average" is normally aritzmetic average (geometric average for bacterial parameters) of all sample meastrements for each parameter obtained during "tifonitoring Period"; ",4laximunt" and "Minimurn" are normally extreme high and low meastrements obtained during "Monitoring Period." (Nate to municipals Kith secondary tre8tmen[ requirement: Enter 30-day average of sample measurements under "Average," and enter maximum 7-day average of sample measurements obtained during monitoring period under "Maximum.') 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Qualirv" as specified in permit. 7. Under "No Ex" enter number of sample measurm.ents during monitoring period that exceed maximum (and/or minimum or 7~a} average as appropriate) permit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnniysis" both as "Sample A4easurneent" (actual frequenry of sampling and analysis used during monitoring period) and as "Permit Requirement" specified in permit. (e. g., Euter "Cons," for continuous monitoring, "1i7" for one tiny per week, "/~30" Cor one day per month, "I/90" for one day per quarter, etc.) 9. Enter "Sample Type" both as "Sample Afeasuremenr" (actual sample type used during monitoring period) and as "Fermi! Requirement," (e.g., Enter "Grab" for individual sample, "1411["' far 24-hour composite, "N/A" for rnntinuous monitoring, etc.) 10. Where violations of permit requirements are reported, attach a brie[ eeplanation to describe cause and corrxtive actions taken, and reference eacn violation by dale. 11. [f "no discharge" occurs during monitoring period, enter "A'o Discharge" across form in place of data entry. 12. Enter "Namer/'iUe ojPrincipa! Executive O)Tcer" with "Signasure ojPrincipal Executive Officer ojAushorized Agent," "Telephone Number," and "Dgse" at bottom of Corm. 13. Mail signed Report to Office(s) by date(s) specked in permit. Retain copy for your records. 14. More detailed instructions for use of this Discharge Aonitoring Repots (DMR) form may be obtained from Office(s) specified in permit. Legal Notice Tlils report is :equired by ;aw (33 U.S.C. 13[8; 40 C.F.R. 125.27). Failure to report cr failure to report truthfully can result in civil penalties not to exceed E10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation, or by imprisonateot for not more than one year, or by both. EPA Form 3320-1 (Rev. 03-95)