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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 en average per response for some minor facilities, to 110 hours as an average per respoose for some major facilities, with a weighted average fo^ major and minor facilities of 18 hours per respoose, including time for reviewing InStNCClmnS, searching ezis:ing data sources, $ithering and maintaining the data needed, and complEtieg and reviewing the collectiom of information. Send comments regarding the burden estimate or any other aspect of this collec'.ien of information, including suggestions for reducing this burden, to Chief, information Policy Branch, Pbt-223, U.S. Environmental Drotection Agency, 401 M Street, SW Washington, DC 20460; and to the Office of Information end Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. General Ins±r;~ctions 1. If form 6•is been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Eo1er 'Permittee .Name~it~ailing 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 'Aonitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Smmple Measurement" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally ac thmetic average (geometric average for bacterial parameters) of all sample meastrements for each parameter obtained during "Sloniloring Period'; ".4Jaximum" and "Miremwn" are normally extreme high and low measurements obtained during "Monitoring Period." (Note to municipals with secondary trcatrnent requirement: Enter 30-aq• average oC sample measurements under "Average," and enter maximum 7~ay average of sample neasurements obtained during monitoring period under "lvlarimum.') 6. Enter "Permit Requirement" Cor each parameter under "Quantity" and "Quality" as specified in pennil. 7. Under "Nn Fx" enter numbc: of sample measurnents during monitoring period that exceed maximum (and/or minimum or 7-day average us appropriate) permit requirement for each parameter. If none, enter "0". 8. Enter "Fregvenct• oj,4nnlysis" both as ".Sample tileasurment" (actual frequency of sampling and analysis used dunng monrtorine period) and as "Permit Requirement" specified in perm[. (e.g., Emer "font," for continuous monitori:~g, "!/T' for one day per week, "/: 30" for one day per month, "1 ~9D" for one day per quarter, etc.) 9. Enter "Sample Ttpe".boGt as "Sample beasurement" (actual sample type used during monitoring period) and as "Perniit Requirement," (ag., Enter "Grab" for individual sample, "?4Hf" for 24-hour composite, "NiA" for continuous motutonng, etc.) 10. Where violations of permit requirements are reported, attach a brieCexplanation to describe cause and corutive actions tzker, znc reference each violation by date. 11. tf "no discharge" xcurs during moni[orng period, enter "h'o Discharge" across form in place of data envy. 12. Enter "Name/1'itle ojPrincipal Executive Dicer" Hi[h "Signature ojPiincipal Executive Officer ojAu(horized Agent," "Telephone Number," and "Dale" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in pemtit. Retain copy for your records. 14. More detailed inslNCtions for use of this Discharge 6Joniroring Report (DAfR) form may be obtained from Office(s) specified in pennil. Legal Notice This report is recuired by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure m report cr failure [o report :Nthfully ran result in civil penalties oat to exceed 510,000 per day of violation; or in mminal penalties cot to exceed 525,000 pzr clay of violatioa, or by impriwnment for oat morn than one year, or by both. EPA Fore 3320-5 (Rev. C8-SS)