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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 I ]0 hours as m average per response for some major facilities, with a weighted average for major and minor facilities of IH 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 20460; end 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 NameMniling Address (and facility name/location, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'Afonitoring Period" covered by form Nhere indicated. 4. Enter each "Poranr~°te.-" as specified i:r monitoring requirements of permit 5. Enter "Sample Aleneurement" data for each parameter under "Qunnnty" and "Quality" in units specified in permit. ".overage" is normally arithmetic avenge (gcondric aceragc for bacterial parameters) of all sample measurements for each parameter obtained during "Monitoring Period'; ",tloxirrrum" and 'Sllinimum" are normally extreme high and low measurements obtained during "Afonitorvng Pened." (Note io municipals with secondary Vea:ment requirement' Enter JO-0ay average of :ample measurements under "Average," and enter mvdmum 7-day average of sample measurements obtained during monitoring period under "Maximum. 6. Enter "Permit Requirement" for each prrameter under "Quan(iN" and "Quality" az specifed in permit. 7. Under "No Ex" enter number of sample measuemen[s during monitoring period that exceed maximum (and/or minimum or 7~ay average az a~propnate) permit requirement for each parameter. If none, enter "0". 8. Enter "Frequency oj.4naly.;is" both as "Sample tifeacunnent" (actual frequency of sampling and analysis used during monitoring period) and as "Permit Requirement" specified in permit. (e.g., Enter "Cont," for continuous monitoring, "l ~7" for ; ne day per week, "lij0" I'or one day per month, "1190" for one day per quarter, etc.) 9. Emer "Sample Tvpe" both az ".Sample dleasur;menP' (actual sample type used during monitoring period) and az "Permit Requirement," (e.g., Enter "Grab" fi>r indi~~dual sample, "14HC' for 24-hour composite, "N/A" 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. 11. U "no discharge" occurs during monitoring period, enter "No Discharge" across form in place o(data entry. 12. Enter "Name/Ti!!e ojPrincipal Executive O~~~er" with "Signature ojPrincipa! Executive OJ~cer ojAuthorized Agent," "Telephone Number," and "Date" al bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in perntil. Retain copy for your records. 14. More detailed instructions for use of this Discharge Afonitoring Report (D,'L1R) form tray be obtained from Office(s) specified in permit. Legal Notice This 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 ~rtdttalties not to excced 510,000 per day of 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 Form 3320.1 (Rev. 08-95)