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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of ]0 hours as an average per response for some minor facilities, to 1(0 hours as an average per response for some major facilities, with a weighted average for major a¢d minor facilities of 18 hours per response, including time for reviewing instructioos, searehi¢g existing data sources, gathering and nia:ntaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burde¢ estimate or any other aspect of this collection of information, including suggestions for reduci¢g this burden, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washingto¢, DC 204b0; and to the Office of Information and Regulatory Affairs, Office of C\~ianagement a¢d Budget, Washi¢gto¢, DC 20503. Genepai. Instructions 1. If form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. Z. Enter 'Permi!!ee Name/Mai/ing Address (and facility namefloca[ion, if different)," "Permit Number," and "Gischarge Numher" where indicated. (A separate form is req tired for each discharge.) 3. Enter dates beginning and ending ':L4oniroring Period" coverui by Conn where indicated. 4. Enter each "Parnnrerer" as specified in monitoring requirements of permit. 5. Enter "Sample Afeasurernen!" data Cor each parameter under "Qunnlity" and "Quality" in units specified in permit. "Average" is normall}• arithmetic average (geometric average for bacterial parameters) of all sample measurements Cor each parameter obtained during "Mnnimring Period"; "dlsxirnum" and "Afinimum" are normally extreme high and low measurements obtained during ",monitoring Period." (Note [o municipals v\i[h secondary treatment requirement: Enter 30-day average of sample measurements under "Average," and enter maximum'-day average of sample measurements obtained during monitoring period order "Masirnum.'J 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" as specified in perntit. 7. Under "No !~" enter number of sample measunnents during monitoring period that exceed maximum (and/or minimum or 7~~.y average as appropriate) permit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnalysis" both as "Sample Measurrnerr" (actual frequenry of sampling and anal}'sis used during monitoring period) and as "Pernrir RequirenrenP' specified in permit. (e.g., Enter "Conn" for continuous monitoring, "//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 as "Sample .Lfeasuremen!" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual sample, "24/IC" for 24-hour composite, "N/A" Cor continuous monitoring, etc.) 10. Where violations of pcrcnit 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 "Name/Ti(le ojPrincipal Executive Officer" with "Signature ojPrincipal Executive Officer ojAulhorized Agent," "Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to CBice(s) by date(s) specified in permit. Retain copy for your records. 14. More detailed instructions for use of this Discharge Afoniioring Report (D.LfR) form may be obtained from O6ice(s) specified in permit. Legal Notice This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.271. Failure to report or fai]ure to report truthfully can result in civil penalties not to exceed x10,000 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)