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Paperwork Reduction Act Notice Public reporting burdee for this collection of information is estimated to vary from a range of l0 hours as en average per response for some minor facilities, to I l0 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 time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regazding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Chief, lnformatiom Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; and 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 et entry of that information already preprinted. 2. Emter 'Permilree ,Vame/Itfailmg Address (and facility ttamelloeadon, if different)," "Permit T%un;ber," and "Discharge Number" where indicated. (A separate form is required for eacl+ discharge.} 3. Enter dates beginning and ending "Afo.vitoring Perod"covered by form where indicated. 4. Enter each "Paromerer" as specified in monitoring requirements of permit. 5. Enter "Sample Mearuremenr" data for each parameter under "Quonlity" ar~d "Quality' in wuts specified in permit. "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements (or each parameter obtained dwing "Afonilonng Period'; "blariumm" and "b/ini+mrm" are normally exKreme high and low measurements obtained durng '9tfonitoring Period." (Note to municipals with secondary treatmem requirement: Emer 30~av average of sample measurements under "Average," and enter maximum 7-day aeeragc of sample measurements ob4nined during monitoring period under "Maximum.') 6. Enter "Perini! Reyu+remenl" fcr each parameter under "Quonlity" and "Quclity" as specified in permit. 7. Under ",Vo Fx" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) perntit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnalysis' both as "Smnplz Aleasrerment" (actual frequency of sampling and analysis used during monitoring period) and as "Pe~ruir Requirement" specified in pemtit. (e.g., Enter "Copt," for rnntinuous monitoring, "/~7" for one day p:r week, "1/30" for one day per month, "1/9("' for one day per quarter, etc.) 9. Enter "Sample Type" both as "Sample Afeasuremenl" (actual sample type used during monitoring period) and as "Fermi! Requirement," (e.g., Enter "Grab" for individual sample, "?41/C' for 24-hour composite, "NiA" Cor continuous monitoring, etc.) l0. Where violations of perntit requirements are reported, attach a brief explanation to describe cause and corective actions taken, and reference each viola;ian by date. l l..Tf "no discharge" occurs during monito ing period, enter "No Discharge" across fotm in place of data entry. 12. Enter "Name/Title ejPrincipni Executive Oj~cer" vvith "Signa(ure ojPrincipal Executive Officer ojAuthorized Agent," "Telephone .Number," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records. 14. More detailed instructions for use of this Discharge A4omtoring Report (DAIR) form may be obtained from Office(s) specified in permit. Legal Notice This report is required by law (33 U.S.C. 1316; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in civil penalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. 08-95)