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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 m average per response forisome major facilities, with a weighted avera~eT r and minor facilities of t8 hours per response,. iycluding time for reviewing instructions, searching exisi~'fa sources, gathering and maintaining the c'a1,7~n ~ded, and completing sod reviewing the collection of intortiratio~ Send comments regarding the burdeA estimate or any other aspect of this collection of information, includ'mg suggestions for reducing this burdeq, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street,.>~ Washington, DC 20460; and to the Office of Information apd Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. General Instructions l:"if, form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. ~~te'r ~rirr-rtee Narne/Mni/ing ABtlIess (and facility name/location, if diderent)," "L'erWitq I jjrmber," and "Discharge Number" where indicated. (A separate form is required (or each discharge.) 3. Enter dates beginning and ending 'iLfonitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements ofpermit. 5. Enter "Sample Measurement" 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"; "d4axirnum" and "Minimum" are normally extreme high and low measurements ob'ained Burin®, "Monitoring Period." (Note [o municipals with secondary treatment requirement: Enter 30~ay average of sgtnple measurements under "Average," and enter maximum 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 Er" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) permit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnal}•sis" both as "Sample Measunnen!" (actual frequency of sampling and analysis used during monitoring period) and as "Fermi( Requirement" specified in permit. (e.g., Enter 'Coot," for continuous monitoring, "1/7" for one day per week, "1/30" (or one day per month, "//90" for one day per quarter, etc.) 9. Enter "Sample Tvpe" both as "Sample Measurement" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" (or individual sample, "14HC" for 24-hour composite, "N/A" for continuous monitoring, etc.) IO. Where violapons of permit requirements are reported, attach a brief explanation to describe pose and corective actions taken, and reference pch violation by date. 11. L` "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name/Tille ojPrincipal Executive OJTcer" with "Signature ojPriricipa! Executive OJTcer ojAuthorized Agent," "'Telephone Number," and "Date " at bottom of form. 13. Mail signed Report to Office(s) by date(s) specked in permit. Retain copy Cor your records. 14. More detailed instructions for use of [his Discharge Alonitoring Repot! (DA1RJ form may be obtained hom 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 ran result in civil penalties mot to exceed $10,1100 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)