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- rti. Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as m average per response for son;e minor facilities, to l10 hours as as average per response for some majo[ facilities, with a weighted average for major and minor facilities of l8 hours per response, including time for'teviewiag instructions, searching existing data sources, gslharing and maintaining the data needed, end completing and reviewing toe collection of iaformatioa. Send comments rega;dug the burden estimate or any other aspect of this collection of infortnaticn, including suggestions ;'or reducing this burden, to Chief, Information Policy Breach, PM-223, U.S. Emvitonmemtal Protection Agency, 40l M Street, $W Washington, DC 204bo; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. General Instructions I. If form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter "Permlttee Name%1/ailing Addsess (and facility namellocation, if different)," "Permit Number," and "Discharge Number" where indicated.- ~A separate ;otlrt is required for each discharge J 3. Enter dates beginning and ending 'Monitoring Period" covered by form where indicated. 4. Enter each "Parameter" az specified in monitoring requirements of permit. 5. Enter "Sample Measurement" data for each parameter under "Quantity" and "Quality" .n units specified in permit. "Average" is normally ariihmctic average (geometric average for bacterial parameters) of all sample measurements for each parameter obtainer during "Afoniroring Period''; "blaxintum" and "A-finiimm~" are normally extreme high and low• measurements obtained during "Alonitnring Perod." (Note to municipals with secondary treatment requirement: Enter 30-dap average of sample mcas~rcmens under "Average," and enter tt>4ximum 7day average of sample measurements ootained during monitor ag period under "Marimum.'J 6. Enter "Permit Reyuireme,rP' for each para.netcr under "Quantity" and "Quality" as specked in permit. 7. ilnder "h'o Ex" enter number o: szmpic meazurmcnts during monitoring period that exceed maximum (and/or minimum or 7-day avemgc az appropriate) permit requirement Cor each parameter. If none, enter "0". 8. Enter "F,-equencv oJAna,'vsis" both as "Saample MeasurmenP' (actual frequency of sampling and analysis used during nwnitoring period)~and as "Permit Requuenrenr" specified in pennrt. (e. g., Enter "Cant," Cor continuous rnonitorin~ "l.~T' for one c'ay per week, "//30" for one day per month, "/~9U" for one day per quarter, etc.) 9. Enter "Smnple Tvpe" both as "Sample A/easuremenr" (actual sample type used during momtoring period) and az "Fermi! Requirement," (e.g., Enter "Grab" for individual sample, "24NC' for 24-hour composite, "~'J/A" for continuous monitoring, etc.) 10. Where violations of ;,emit requirements are reported, attach a brief explanation to descnbe cause and corrective actions taken, and referent: each violation by date. 11. If "no tiiscilargc" occurs during monitoring period, enter "Mo Discharge" across for[n in place of data entry. 12. Enter "Nome/Title ojf'rin~ipa! Executive Officer" tvilh "Signature ojPrincipal Executive Officer ojAuthcrized Agent," "Tr•:ephone Number," and "Date" at bottom of form. 13. Mail signed Repon to O13ice(s) by date(s) specified in pernti[. Retain copy for yore records. 14. More de'aied insttvctions for use of this Discharge Alonitnring Report (DAIR) form may be obtained Gom Office(s) specified in permit. Legal Notice This report is required b} law (33 U.S.C. 1318; 40 C.F R. ]25.27). Failure to report or failure to report t.-uthfully can ."CSUtt m CiVl1 peF~OitiG not G'• excuxl 510,000 per day of violation; or in criminal penalties not to exceed (25,000 per day cf violation, ar by imprisorlmen[ rot not more than one year, or by both. EPA form 33?0-1 i:tev.'38--'IS)