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' ; - I . Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as m
<br />average per response for some minor facilities, to 110 hours as an average per response for some major facilities,
<br />with a weighted average for major wd, minor facilities of 18 hours per response, including time far reviewing
<br />instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
<br />v m8 the collection of information. Send comments regarding the burden estirmte or any other aspect of
<br />collectiorc of information, including suggestions for reducing this burden, to Chief, Information Policy
<br />~~; PM11,~3, U.S. Enviroruoerctal Proration Agency, 401 M Street, SW Washington, DC 20460; and to the
<br />Office oPlnfpfination and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
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<br />General Instructions
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<br />has been partially completed by preprinting; disregard instructions directed at entry of that information
<br />preprinted.
<br />'Permiffee Name/,Nailing Address (and facility name location, if different)," "Permit Number," and
<br />urge Number" where indicated. (A separate form is required for each discharge.)
<br />,~ ~hte~'dates beginning and ending 'iLJoniroring Period" covered by form where indicated.
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<br />rrh"~nter each "Parameter" as specified in monitoring requirements of permit.
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<br />a5: Enter "Sample Measurement" data for each parameter under "Quantity" and "Quality" in units specified in permit.
<br />t ' "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measuuements
<br />ier each parameter obtained during "Monitoring Period'; "tifarimum" and "Minimum" are normally extreme high
<br />and bw meastrements obtained during "Afonitoring Period." (Note to municipals with secondary treatment
<br />' requirement: enter 30-day average of sample measurements under "Average," and enter maximum 7-day average
<br />of sample measurements obtained during monitoring period under "Maximum.')
<br />fi. Enter "Permit Requiremen(" for each parameter under "Quantity" and "Quality" as specified in permit.
<br />r7. Under ",Vo Ex" enter number of sample measurments during monitoring period that exceed maximum (and/or
<br />minimum or 7.day average as appropriate) permit requirement for each parameter. if none, enter "0".
<br />~. Enter. "Frequency ojArrafysis" both as "Sample rLfeasurnrent." (actual frequenry of sampling and analysis used
<br />fs during monitoring penod) and as "Permit Requirement" specified in pernut. (e.g., Enter "Coot," for continuous
<br />• anoniloring, "1 i7" for one day per week, "1.30" for one day per month, "1/90" for one day per quarter, etc.)
<br />39, :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, "24HC' for 24-hour composite, "N/.4" for
<br />continuous monitoring, etc.)
<br />)r(1 'Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />'actions taken, and reference each violation by date.
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<br />~~~. If "no discharge" occurs during monitoring period, enter "No Dischorge" across form in place of data entry.
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<br />!$. ,Enter "Name/f'i!!e ojPrincipnJ Executive Officer" with "Signature ojPrincipa! Executive Officer ajAuthorized
<br />~::' Agenf," "Telephone Number," and "Dale" a[ bottom of form.
<br />Mail signed Report to Office(s) by date(s) specified in pernti[. Retain copy for your records.
<br />More detailed instructions for use of this Discharge Monitoring Report (DrL1R) form may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />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
<br />t Jn civil penalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />~~tion, or by imprisonment for not more than one year, or by both.
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<br />EPA Form 3320-1 (Rev. OS-95)
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