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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of l0 hours as an average per response for some minor facilities, to 110 hours as eo average per response for some major facilities, with a weighted average for major and minor facilities of 18 hours per response, includwg time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and wmpleting and reviewing the collection of unformation. 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; and to the Office of Information and Rebvlatory Affairs, Office of Management and Budget, Washington, DC 20503. . General Instructions 1. If form has beam partially completed by preprinting, disregard instructions directed at entry of Wat ulformatiom already preprinted. 2. Eater "Permittee NarneMailing 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 'Monitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specked in monitoring requirements of permit. 5. Enter "Sample MeasuremenP' data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements for each parameter obtained during "Monitoring Period'; "A4axirnum" and "Minimum" are normally extreme high and low measurements obtained during "Monitoring Period." (Note to municipals with secondary treaunent requirement: Enter 30-day average of sample measurements under "Average," and enter mutximum 7-day average of sample measurements obtained during monitoring period under "Maximum.') 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" as specified in permit. 7. Under "No Fx" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) permit requirement Cor each parameter. If none, enter "0". 8. Enter "Frequency ojAnalysis" both as "Sample Measunnent" (actual frequency of sampling and analysis ased during monitoring period) and as "Fermi( Requirement" specified in permit. (e.g., Enter "Conn," for continuous monitoring, "I/7" for one day per week, "1/30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Type" bo0t as "Sample Measure»rent" (actual sample type used during monitoring period) and as "Permit Requirement," (c.g., Enter "Grab" for individual sample, "24HC' far 24-hour composite, "N/A" for continuous monitoring, etc.) 10. Where violations of permit requirements are reponed, attach a brie( explanation to describe cause and cortective actions taken, and reference each violation by date. 11. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name//'ille oJPrincipal Executive Dicer" with "Signature ojPrincipal Executive Officer oJAulhorized Agent," "Telephone Number," and "Date' at bottom of forth. 13. Mail signed Report [0 O6ice(s) by date(s) specified in perntit. Retain copy for your records. 14. More detailed instructions for use of [his Discharge Monitoring Report (DMR) form may 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 penalties mot to exceed 510,000 per day of violation; or in criminal penalties mot to exceed $25,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. OS-95)