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Paperwork F;eduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as a~
<br />average per response for some minor facilities, [0 110 hours as an avemge per response for some major facilities,
<br />with a weighted average for major and minor facilities of 18 hours per response, including time for reviewine
<br />instructions. searching axisting data sources, gathering and maintaining [he data needed, and completing and
<br />reviewing We collection of information. Send comments regarding the burden estimate or any other aspect of
<br />this collection of information, including suggestions for reducing this burden, to Chief, lnformatioo Policy
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; and to the
<br />Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. '~
<br />General Instructions
<br />1. If form, has been pamally completed by preprinting, disregazd instructions directed at entry of that information
<br />already preprinted.
<br />2. Enter 'Permittee A'ome~Afailing Address (and facility namellocation, if different)," "Permit Nwnber,' and
<br />"Discharge !['umber" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning, and ending '~lfoniroring Period" covered b} form where indicated.
<br />4. Enter each "Poramerer" as specified in monitoring requirements ofpernit.
<br />5. Enter "Sample ,4feosm-emrnt" data for each parameter under "Quantity" and "Qualih~" in units specified in permit.
<br />"A,~ernge" is nornralh~ arithmetic average (geometric average for bacterial parameters) of all sample measurements
<br />for each parameter obtained during "dfonitoring Periud'; ",'tfaximum" and 'Sllmi;num" are normally e~ttremc high
<br />and.loW measurements obtained during ".tonitoring Period." (Vote to munocipuls «ilh secondary treatment
<br />requirctnenc Enter 30~av avemge of sample measurements under "Average," and enter maximum 7-day average
<br />of sample measurcments obtained during monitoring period under ",1 faximum.
<br />6. Enter "Permit Regwrement" Cor each parateter under "Quantity" and "Quality" as specified in pcmtil.
<br />7. Under "Nu Ex" enter number of sample measunnents during monitoring period that exceed maximum (and/or
<br />minimum or 7-day average as appropnate) pcrnit requirement for each parameter. U none, corer "0".
<br />8. Enter "Frequency o~ 4nalysis" both as "5'arn,~le Alea.rurment" (actual frequency of sampling and anal}'sis used
<br />during monitoring period) and as "Permit Re,iuir:utent" specified in permit. (e.g., Enter "Coot," for continuous
<br />moniloting, "1/7" for one day per week, "I/30" for one day per month, "//90" for one day per quarter, etc.)
<br />9. Enter i°Sample Tvpe" both as "Sample ,tfeasurement" (actual sample type used during monitoring period) and as
<br />"Fermi! Requirenrerrt," (e.g., Enter "Grab" f'or individual sample, "?,tf1C" for 24-hour composite, ",~''/A" for
<br />continuous monitoring, etc.)
<br />10. Where 'violations of permit requirements are reported, attach a brief explanation to describe cause and corective
<br />acuons'taken, and reference each violation by date.
<br />11. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
<br />12. Enter '~Name;Title rjPrincipal Executive OJJicer" with "Signature ojPrincipa! Executive Officer oJAuthorized
<br />Agenl,'r "Telephone Number," and "Date" a[ bottom of farm.
<br />13. Mail signed Report to Office(s) by date(s) specified in perntit. Retain copy for your records.
<br />l4. More detailed instructions for use of this Discharge Monitoring Report (DMRJ form may tx obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />This report isl required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can
<br />result in civilpenelties not to exceed;10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />of violation, br by imprisonment for not more than one year, or by both.
<br />EPA Form 31320.1 (Rev. 08-95)
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