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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 some minor facilities, to 110 hours as an average per response far 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, Information 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 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 Name/Mailing Address (and facility namellocation, if different)," "Permit Number," and "Discharge Number" where indipted. (A separate form is required for each discharge.) 3. Enter dates beginning and ending "Monitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample ,l-feasurement" data Cor each parameter under "Quantity" and "Quality" in units specSed in permit. "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements for each parameter obtained during "il/onitoring Period"; ">tifaximum" and ",i4inimum" are normally extreme high and low measurements obtained during "hfo.airoring Period." (Note to municipals with secondary treaunent requirement: Enter 30-day average of sample measurements under "Average," and enter maximum 7-0ay average of sample measurements obtained during ntonit~ring period under "Maximum.') ' 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" as specified in permit. 7. Under "No Er" enter number of sample measuements during monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) perntit requirement for each parameter. U none, enter "0". 8. Enter "Frequency ojAna(ysis" both as "Sample Measurment" (actual frequency of sampling and analysis tssed during monitoring period) and as "Permit Requirement" specified in permit. (e.g., Enter "Copt," for continuous monitoring, "l/7" for one day per week, "1/30" for one day per month, "//90" for one day per quarter, etc.) 9. Enter "Sump/e Type" both as "Sample MeasuremenP' (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" fur individual sample, "24HC" for 24-hour composite, "N/A" for continuotu monitoring, etc.) 10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. I I. Tf "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name/Ti(le ojPrincipal Executive Officer" with "Signature ojPrincipnl Executive Oi7icer ojAuthorized Agent," "Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in perntit. Retain copy Cor your records. 34. More detailed instructions for use of this Discharge Monitoring Report (DMR) form may be obtained from Office(s) specified in permit. Legal Notice 'ibis 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 x10,000 per day ~~f 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 Fatm 3320-1 (Rev. 08-95)