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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 en average per response for some minor facilities, to 110 hours as m 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, 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 this collection of informatior, including suggestions for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 40l M Street, SW Washington, DC 20460; end to the Office of Information and Regulatory Affairs, Office of Management end Budget, Washington, DC 20503: . General Instructions 1. if form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter 'Permittee Narne/Afailing Address (and facility name location, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'iLloniroring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample Mensuremenr" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements for each parameter obtained during "Monitoring Period"; "Maximum" and "Minimum" are normally extreme high and low measurements obtained during "Monitoring Period." (Note to municipals with secondary treatment requirement: Enter 30~ay average of sample measurements under "Average," and enter maximum 7day average of sample measurements obtained during monitoring period tinder "Maximum.') 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" az specified in perm[. 7. Under "No Ex" enter number of sample meazurments during monitoring period that exceed maximtun (and/or minimum or 7-day average az appropriate) permit requirement for each parameter. ff none, enter "0". 8. Enter "Frequency ojAnalysis" both az ",Sample ,tleasunrtent" (actual frequency of sampling and analysis used during monitoring period) and az "Permit Requirement" specified in pernti[. (e.g., Enter "font," for continuous monitoring, "I/7" for one day per week, "1/30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Tvpe" both az "Sample Measurement" (actual sample type used during monitoring period) and az "Perini! Requirement," (e.g., Enter "Grab" for individual sample, "14HC' (or 24-hour composite, "N/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 inference each violation by date. 11. If "no discharge" occtus during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name/I'ille oJPrincipa! Executive Officer" with "Signature ojPrincipal Executive Officer ojAuthorized Agent," "Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to OtTice(s) by date(s) specified in pemtit. Retain copy for your records. 14. More detailed instructions for use of this Discharge hfonitoring Report (DMR) form may be obtained from Office(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 penalties not to exceed S 10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. 08-95)