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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 m average per response for some minor facilities, to 110 hours as rn average per response for some major facilities, with a weighted average fo: major and minor facilities of 18 hours per response, including time for reviewing instructions, searching ez~sting data sources, gathering and maintaining the data seeded, and completing end reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for redu~;ing this burden, to Chief, Infortnatioo 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, Washington, DC 20503. General Instructions 1. if form has been partially completed by preprinting, disregard instructions diruted at entry of that information already preprinted. 2. Enter 'Permittee Name/blailing Address (and facility name location, if di@'erent);' "Permit N'umber," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'iLfonitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample ~Lfeasuremenr" data Tor 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"; "Alzximum" and "Minimum" are normally extreme high and IOrV measurements obtained during ",monitoring Prrio,i." (Note to municipals with secondary treatment requirement: Enter 30-day average of sample measurements under "Average," and enter maximtun 7-day avemge 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 "Na Ex" enter number oC sample meacurmen[s 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 ,Lleosunnent" (actual frequency of sampling and analysis used during monitoring period) and as "Pennir Requirement" specified in permit. (e.g., Enter "Cons," for continuous :monitoring, "//7" for one day per week, "//30" for one day per month, "//90" for one day per quarter, etc.) 4. Enter "Sample Type" both as "Sample Mensurement" (actual sample type used during monitoring period) and as "Permit Regvirernent," (e.g., Enter "Grob" for individual ample, "14HC"' for 24-hour composite, "NSA" for continuous monitoring, etc.) IC. 'Nhere violations of permit requirements are reported, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. I I. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enrer "Name/Tille ojPrincipal Executive Officer" with "Signature ojPrincipnl Executive OJTcer oJAuthorized Agent," "Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records. 14. DAare detailed instructions for use of this Discharge Monitoring Report (D~t1RJ form may be obtained from O(i5ce(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 in criminal penalties not to exceed 525,000 per day of violation, ar by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. OS-95)