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Paperwork Deduction 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 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 regarding 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 204b0; 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 at entry of that information already preprinted. 2. Enter 'Permi((ee NameMailing Address (and facility ttame/loca[ion, if diH'eren[)," "Permit Number,' and "Discharge Number" where indicated. (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 Aleacuremenr" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally arithmetic average (geometric average far bacterial pazameters) of all sample measurements for each parameter obtained during "Monitoring Perlod'; "bfazirnu,n" and "Minimwn" arc normally extreme high and low measurements obtained during "rLfo.nitoring Period." (Note ;o municipals with secondary treatment requirement: Enter 30-day average of sample measurements under "Average," and enter maximum 7~ay average of sample measurements obtained during monitoring period under "A4aximum. 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" as specified in permit. 7. Under "No Er" enter number of sample mensurments during monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) perniit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnalysis" both as ".Snmlrle ,Neasunnent" (ac:ual frequency of sampling and analysis used during monitoring period) and as "Permit Re,•virerueur" specified in permit. (e.g., Enter "Copt," for continuous monitoring, "1/7" for one day per week, "//30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Type" bath as "Sample Measurement" (actual sampte type used during monitoring period) and as "Permi! Requirement," (e.g., Enter "Grab" for individual sample, "1471C' for 24-hour composite, "N/F" for continuous 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. 1 I. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name/title ojPrincipa! Executive Officer" with "Signature ojPrincipal Ereculive Officer ajAuthorized 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 instmctions for use of [his Disch~rrge Monitoring Report (D.I1R) form may be obtained from Office(s) specified in permit. Legal Notice This report is required by law (33 U.S.C. ]316; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in civil penalties not to exceed 310,000 per day of violation; or in criminal penalties not to exceed 325,01)0 per day of violation,~or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. OS-95)