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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 response for soma minor facilities, to 110 hours as m average per response for some major facilities, with a weighted average for major end tttinor facilities of IB hours per response, including time for reviewing instructions, searching existutg data sources, gatliering and tt[aintaining the data needed, end cottlptetiog snd reviewing the collection of htfonnation. Send comments rega*ding the burden estimate or any otha~;yepect of this collection of information, including suggestiors for reducing this burden, to Chief, [nfonnatioa Policy Branch, PM-223, U.S. Environmental Protection Agency, tr01 M Srreet, SW Washington, DC 2l)4b0; end to the Office of Information and Regulatory Affairs, Office of Management and 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 Name/Adai/ing 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 'iLlonitoring Period"covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample Measurement" data for each parameter under "Quantity" and "Qunlity" in units specified in permit. ",4verage" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements for each parameter obtained during "Afonitoring Period"; "Marimurn" and "Afininrum" are normally extreme high and low measurements obtained during ",t/onitenng Period." (Note to municipals with secondary treatment requirement: Enter 30-da~~ average of sample measurements under "Average," and enter maximum 7-tlay average of sample measureirtcnts ooiained during monitoring period under "Maximum.') 6. Enter "Permit Requiremem" for each parameter under "Quantity" and "Qvaliry" as specified in permit. 7, Under "h'o Fs" enter number of sample measurments during mottitoring period that exceed maximum (and/or minimum or 7-day average as appro;rriate) permit requirement for each parameter. ff none, enter "0". 8. Enter "Frquency njAnnlysis" both as "Sanple Aeasurment" (actual frequency of sampling and analysis used during monitoring period) anti as "Permit Requir:ment" specified in permit. (e.g., Enter "Coot," for continuous monitoring, "f/7" for one nay per :rcek, "1 30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Type" both as "Sample Measurement" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g.. Enter "Grab" for individual sample, "2dHC" for 24-hour composite, "NiA" for continuous monitoring, etc.) 10. Where violations of permi: requirements are reported, attach a brief explanation ;o describe cause and corrective actions taken, and reference each violation by date. 11. If "no discharge" occurs during monitoring period, enter "h'o Discharge" across form in place of data entry. 12. Enter "Name/1'itle ojPrincipa/ Executive O~cer" with "Signoture ojPrincipa! Executive Officer njAuthorized Agent," 'Telephone Numbe•," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by dale(s) specked in permit. Retain copy for yow records. 14. More detailed instructions for use of this Cischnrge Aonitoring Report (D,f'iR) form may be obtained from Office(s) specified in permit. Legal Notice This report is required'oy law (35 U.S.C. 13;B; 40 C.F.R. 125.27). Failwe to report or failure to report truthfully can result in civil penalties not to excred $10,000 per day of violation; or in criminal penalties not to extent $25.000 per day of violstioo, or by imprisonment for not more than one year, or by both. RPA Form 3320-1 (nev. OB 9S)