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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 110 hours as an average per respoose for some major facilities, w;<qt a weighted average for major and minor facilities of. IjE}pttrs per response, including time for reviewing IoiGtggtioosr searching existing data sources, gathering °BffQ`mainriining the Data needul, and completng anJ revievd'mg the collection of in Formation. Send comments regarding file burden estimate or any other aspect of this collection of infcrrmtioo, iocluding' suggestions for reducing ties burden, to Chief, information Policy Branch, PM-223, U.S. EnviroamentalProtectioo Agency, 401 M Street, SW Washington, llC 20460; end to tha Office of Information and Regtlatory 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 "Permittee Name%t,niling Address (and facility nameJlocation, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'iLlonitoring Period" covered by form where indicated. 4. Enter each "Parameter" as ~necified in monitoring requirements of permit. 5. Enter "Sample Measuremer t" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally arithmetic average (geometric average for bacterial parameters) or all sample measurements for each parameter obtainai during "Afonitoring Perrod'; "Maximum" and ":tlinimum" are normally extreme high and low measurements obtained during "Afonita•ing Permd." (Note to municipals wiih secondary treaunent requirement: Enter 30-day average of sample measuremcnis under "Average," and enter maximum 7-day average of sample measurernen's cb wined during monitoring period tinder "Marimeme. 6. Enter "Permit Rerprirernent' for each parameter under "Qunnliy" and "Quality" as specified in permit. 7. Under "No Es" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7-day average ~ apuroariate) permit requirement for each parameter. if none, enter "0". B. Enter "Frequency ojAnalrsis' both as ".Sample A9easurment" (actual frequency of sampling and analysis used during monitoring period) snd as "Per-rnit Requir•ernenl" specified in permit. (e.g, Enter "Cont." for continuous monitorng, "li7" for one dray per week, "I/30" (or one day per month, "//90" for one day per quarter, etc.) 9. Enter ".Sample Type" both as ".Sample ,lfeasuremenP' (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual sample, "?411C" for 24-hour composite, "NiA" for continuous monitoring, etc.; 10. Where violaIions of permit requirements are reported, attach a brief explanation to describe cause and corrective actions take4 and reference each violation by date. 11. If "no discharge" occurs during monitoring period, enter "No Drscharge" across form in place of data entry. 12. Enter "Name/title ojPrincipal Executive Officer" frith "Signature ojPrincipa! Executive Ojrcer ojAuthorized Agent," "Telephone IJumber," and "Date" at bottom o(form. 13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records. l4. More detailed instructions Cor use of this Discharge Aonitoring Report (DMR/ form ma}• be obtained from Offiice(s) specified in permit. Legal Notice TSis 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 not to excud $!0,000 per day of violation; or in criminal panalnes not to exceed 525,OC+0 per day of violation, or by imprisonment for not more than one ycu, or by both. EYA Form 3320-1 (Scv. US-95)