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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 ai~v;rage per response for some minor facilities, to 110 hours as an average per response for some major facilities; iL~ a weighted average for major and minor facilities of 18 hours per response, including time for reviewing instnrctions, 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 asp);ct of this collection of information, including suggestions for [educing Wis,burdea, to Chief, laformatiom Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washutgtoa, DC 20503. General Instructions l.`if form has been partially completed by preprinting, disregard instructions directed at entry of that information ,$Iready preprinted. -- _ __v, _ _ ..._ 2. Enter "Permittee Name/Jl;ailing Address (and facility name/location, if different)," "Permit /Dumber," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. _ Enter dates beginning and ending 'iLloniroring Period" covered by form where indicated. 4.'Enter each "Parameter" as specified in monitoring requirements ofpermit. 5. Enter "Sample Measurement" data Cor 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 .Cor each parameter obtained during "Monitoring Period'; "Maximwn" and "Minimum" are normally extreme high and low measurements obtained during "Monitoring Period." (Note to municipals with secondary treatment requirement: Enter 30-day average of sample 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 Fx" 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 ojAnalysis" both as "Sample Measunnent" (;tctual frequenry of sampling and analysis used during monitoring period) and as "Permit Requirement" specified in permit. (e.g., Enter "Copt," for continuous monitoring, "1/7" for one day per week, "1/30" for one day per month, "!/90" for one day per quarer, etc.) 9. Enter "Sample Tvpe" both :ts "Sample Measurement" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual 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. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Namelfttle ojPrincipa! Executive Officer" with "Signature ojPrincipa! Erecrrtive Officer ojAuthorized Agent," "Telephone Number," and "Date" a[ bottom of form. 13. Mail signed Report to Office{s) by dale(s) specified in pern»t. Retain copy for your records. 14. More detailed instructions for ttse of this Discharge Monitoring Report (DMRJ form may be obtained from OBice(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 not to exceed 510,000 per day of violation; or is criminal penalties not to exceed 625,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Fortin 3320-1 (Rev. 08-93)