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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated [o vary from a range of 10 hours as aD average per response for some minor facilities, to 110 h~urs as m aYerage per response for some major facilities, with a weighted average for major and wino[ facilitiespElB;hours per [espouse, including time for reviewing instructions, searching existing data sources, galltg'and (naiDtaining the data Deeded, and completing and reviewing the collection of information. Send mrnmenls rega[ding the burdeD estimate or any other aspect of this collectioD of information, including suggestions for reducing this burden, to Chief, InformatioD Policy Branch, PM-223, U.S. EovironmeDtat ProtectioD Agency-~IQ), M Street, SW Washington, DC 20460; end to the Office of Information and Regulatory Affairs, Office of Ivfanagemeot and Budget, WashingtoD, DC 20503. General Instructiot~ ~'' ~~ ~ '- l. (f form has been partially completed by preprinting, disregard instructions.directed at entry of that information afieady prepfinted. 2. Enter "Permiltee Name/Mailing Address (and faality name/location, if different)," "Permit Nuprber," and ' -"Discharge Number" where indicated. (A separate form is required for each discharge.) ~" 3. Enter dates beginning and ending 'i4foniioring Period" covered by form where indicated. 4. Enter each "Parameter" az specified in monitoring requirements of permit. 5. Enter "Sample A4eruvrement" 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'; "Mazimuln" and "Minimum" are normally'ex[reme high and low measurements obtained during ",monitoring Period." (Note to municipals µ~th secondary treatment requirement: Enter 30-day average of sample measurements under "Average," and enter maximum 7day average of sample measurements obtained during monitoring period under "Alaximum. 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" az specified in permit. 7. Under "No Ex" enter number of sample measurments during monitoring period that exceed maximum (and/or minimum or 7~ay average az appropriate) permit requirement for each parameter. If none, enter "0".. - 8. Enter "Frequency of Analysis" both az "Sample Measunrent" (actual frequency of sampling and analysis used during monrtoring period) and az "Fermi! Requirement" specified in permit. (e.g., Enter "Coot," for continuou monitoring, "1/7" for one day per week, "1/30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Type" both az "Sample Measurement" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual sample, "2a11C' 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 Corm in place of data entry. 12. Enter "Name//'ifle ojPrincipa! Executive Officer" with "Signature ojPrincipal Executive Officer ojAuthorized Agent," "Telephone Number," and "Date" at bottom oCform. 13. Mail signed Report to Office(s) by date(s) specified in perntit. Retain copy for your records. 14. More detailed inslmclions for use of this Discharge Monitoring Report (DMR) Corm 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. 125.2'7). Failure to report or failure to report truthfully can result in civil penalties Dot to exceed SI0,000 per day of violation; or in criminal penalties not to exceed S25,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Ilev. 08-95) ,_~