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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 an average per response for some minor facilities, to 110 hours as an average per response for some major facilities, with a weighted average for major and minor facilities of 18 h~~urs per response, including time for reviewing infractions, 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 aspect of this collection of information, including suggestions for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Environrrrenta' Protection Agency, 401 l1i Street, SW Washington, DC 204b0; and to the Office of Information and Regulatory Affairs, Offtce of Management and Budget, Washington, DC 20503. General Instr~:ctions 1. If form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter "Permittee NameMailing Address (and facility namellocation, if di$'erent)," "Permit Numher," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending "Lfoniroring Period" covered by form where indicated. 4. Enter each "Parmneter" as specified in monitoring requirements of permit. 5. Enter "Sample rL/easurernent" data for each parameter under "Quantity" and "Quality" in units spcc~ed in permit. "Average" is normally arithmetic a~: erage (geometric avemge for bacterial parameters) of all sample measurements for each parameter ebtained during "Monitoring Period"; "Mraimmu" and "Ahnimum" are normally extreme high and low measurements obtained during ",'Llonttoring Period." (Note to municipals with secondary treatment requirement Enter 30~ay average of sample measurements ;ruder "Average," and enter maximum 7~ay average of sample measurements obtained during monitoring period under "Maximum.') 6. inter "Permit Requirement" for each parameter under "Quanri.y" and "Quality" as specified in permit. 7. Under "No Ex" enter number of sample measurments d~rring monitoring period that exceed maximum (and/or minimum or 7-day average as appropriate) permit requirement for each parameter. [f none, enter "0". £. L•nter "Frequenc~~ oJ,4nalysis" both as "Sample A,/easurmen!" (actual frequenry of sampling and analysis used during monitoring period) and as "Fermi( Reyuirentent" specified in permit. (e.g., Enter "Cant,". for continuous monitoring, "J/7" for one day per Heek, "I/30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "S'ample Type" both as "Sample ~1';easurement" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual sample, "241fC" for 24-hour composite, "A%A" for continuous monitoring, etc.) 10. rNhere violations of r"rmit requirements are reported, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. 11. It "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. IZ. Enter "NamelTiNe ojPrincipal Executive Officer" with "Sigra(ure ojPrincipn! Executive Officer ojAuthorized Agent," "Telephone Number," and "Date" al bottom of form. 13. Mail signed Report to Cf3ice(s) by date(s) specified in perntit. Retain copy for your records. 14. More detailed instructions far use of this Discharge Monitoring Report (DAfR) 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 not to exceed 510,000 per day ofviolation; 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)