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Paperwork llteduction Act Notice Rublic reporting burden for this collection of information is estimated to vary from a range of 10 hours as an average par response for some minor facilities, [e 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 lime for revievutg 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 [his collectioa of information, including suggestions fur reducing this burden, to Cltief, (nfortnatioo Policy Branch, PM-223, U.S. Environmental Protea;lion Agency, 401 M Street, SW Washington, DC 20460; and W the Office of Information and Regulatory Affairs, Oft ice of hfanagement and Budget, Washington. DC 20503. General Instructions 1. If fora[ has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter "Permittee Nome Mailing Address (and facility nameJlocation, if different)," "Permit Number," and "Discharge h'unrber" where indicated. (A separate Corm is required Cor each discharge.) 3. Enter dates beginning and ending "'Llonitormg Period" covered by form xhere indicated. 4. Enter each "Parameter" as spceified in monitoring requirements of permit. S. Enter "~Samplc .1lcasurenrent" data for each pammeter under "QuontiN" and "Qua/r N" in [mils spxilied in per-nit. ".averyg~" is nornialh arithmetic average (gcometnc average for bacterial parameters) of all sample measurements for cash parameter outaincd daring ".Lfanrlorirg Period"; "Alaxunurn" and ".1 finJnum" are normally e~Veme high and lox mcasuremculs obtained during ".llomroring Period" (Note to municipals xilh seeondar}~ Ireatmerl requitement'. Emer 30-day avcmgc of sample meastucmcnts under "Average;' ;tad enter maximum 7-0a} a:emge of sample meastuements obtained during monitoring period under ".1laximum 6. Enter "Fermi! RequirrmenY' for each parameter under "Quantity" and "Quality" ~. specified in pcnnit. 7. Under i'.No Er" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7ifay average u appropriate) pcnni[ requirement far each parameter If none, inter "0". 8. Enter "Frequency oj.4na/vsis" both as "Sample ,1leorur+nenY' (actual frequc-tcy of sampling and anaJ}'sis used during monitoring period) and as "Perurit Renuirement" specified in permit. (e. g., Emer "Conn" for continuous monitoring, "IiT' Cor one day per week, "l X30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "5antple Type" both as "Sample ,llcasurernenr" (actual sample typo used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual sample, "2J11C' far 24-hour composite, "1J/A" for continuous monitoring, etc.) 10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. 11. If"no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name/Citle of Principal Executive OJ)rcer" with "Signa(ure of Principe( Executive Officer oJAuthorized Agent,"''Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specil ied in permit. Retain rnpy for your records. 14. More detailed instructions for use of this Discharge Monitoring Report (D.1'IRJ form may be obtained from Offce(s) specified in permit Legal Notice This 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 ~enalties not to exceed S 10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day of violatioa, or by imprisonment for not more than one year, or by both. EPA Fotm 3320-1 (Rev. 08-95)