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Paperwork Reduction Art Notice <br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an <br />average per response for some minor facilities, To 110 hours as an average per respense for some major facilities, <br />vrith a weighted average for major and minor facilities of 18 hours per response, including time for reviewing <br />instructions, seazching existing data sources, gathering and maintaining the data needed, and completing and <br />revicvrng the collection of information. Send comments regarding the burden estimate or any other aspect of <br />this coL'ection of information, including suggestions for reducing this border., -o Chief, Information Policy <br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S4?t, lNashingron, DC 204tS0; and to the <br />Office of Information a;rd Regulatory APFairs, Office of Management and 3:~dget, x`tashinoton, llC 20503. <br />General Instructions <br />1. Tf form has been partially completed by preprinting, disregard instructions diracted at entry of that information <br />already preprinted. <br />2. Enter "Permittee Name/Mailing Address (and facility name/iocation, if different)," "Pem:it ,Number," and <br />"Discharge Number' where indicated. (A separate form is required for each discharge.) <br />3. Enter dates beginning and ending "Aonitoring Period' covered by form where indicated. <br />4. Enter each "Parameter' as specified in monitoring requirements of permit. <br />5. Enter "Sample ,bfeasuremenr"data far each parameter under "Quantity" and "Qualit}%' in units specified in permit. <br />"Average" is rormally arithmetic average (geometric average for bacterial parameters) of a0 sample measure- <br />ments for each parameter obtained during "Monitoring Period"; "hlasimum" and "Minimum" aze normally ex- <br />treme high and low measurements obtained during "~'donitoring Per.'od." {tote to municipals With secrndary <br />treatment requirement: Enter 30-day average of sample measurements under "Average;' and enter maximum <br />7-day average of sample measurements obtained during monitoring period under ",btaxinutm:') <br />6. Enter "Pem, it Requirement" for each parameter under "Quantity" and "Quality/' as specified in permit. <br />7. Under ".'Vo Ex" enter number of sample measurements during monitoring period that exceed maximum (and/or <br />minimum o[ 7-day average as appropriate) permit requirement foe each parameter. Tf none, enter "0." <br />8. Enter "Frequency of Analysis" bath as "Sample Measurement" (actual frequency of sampling and analysis used <br />during monitoring period) and as "Permit Requirement" specified in permit. (e.g., Enter "Conn," for continuous <br />monitoring, "1/T' for one day per week, "1/30" for one day per month, "1/97" for one day per quarter, etc.) <br />9. Enter "Sample Type" both as "Sample Measurement" (actual sample type used during monitoring period) and as <br />"Permit Requirement;' (e.g., Enter "Grab" for individual sample, " 24NC" for 23-hour composite, "N/A" for con- <br />tinuousmonitoring, etc.) <br />Z0. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective <br />actions Laken, and reference each violation by date. <br />11. Tf "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. <br />12. Enter "h'nme/Title of Principal Executive Officer" with "Signature of Principal Executive Officer of Authorced <br />Agent," "Telephone Nwnber," and "Date" a[ bottom of form. <br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retaitt copy for your records. <br />14. More detailed instructions fat use of this Discharge eLlonitoring Report (DRIB) form may 6e obtained from Of- <br />fice(s) specified in permtt. <br />Legal Notice <br />This report is required by law (33 C.S.C. 1318; ~0 C.F.A. 125.27). Farlure to ~~~port or failure to repott truthPal(y can <br />result in ci~tii penalties oar to exc'.ed 510,000 per day of violation; or in cri~rrnaf penalties not to e;:ceed x25,000 per day <br />of violation, ar by imprisanmcr.t far not mare than one year, ar by both. <br /> <br />