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Pape~vork Reduction Act N~~~ce
<br />Public reporting burden for this co7fex;tion of information is estimated talm a range of 10 hours as an
<br />average per response for some ' 'lies, to 110 hours as an avt:rage per respoase for some major facilities,
<br />with a weighted average for ma` 'minor facilities of 18 hours per response, including time for reviewing
<br />instructions, searching existing data sources, gathering and,lt~tatning [he data needed, and completing and
<br />reviewing the collection of information. Sand comments ~~ g the burden estimate or any other aspect of
<br />this collection of information. including suggestions` acing this burden, to Chief, Information Policy
<br />Branch, PM-223, U.S. 3nvironmental Protection Agenc 1 W Streit, SW Washington, DC 20460; and to the
<br />Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
<br />General Instructions
<br />t-
<br />1. If form has been partially completed by preprinting, disregard utstructioas directed at entry of that information
<br />alrwdy preprinted.
<br />2. Enter "Permittee Narne/Mai/ing Address (and facility -name/Itxztion, if different)," "Permit Number," and
<br />"Discharge Number" where indicated. (A separate form is required for each discharge.]
<br />3, Enter dates beginning and ending 'Monitoring Period" covered by form where indicatcvi.
<br />4.'Enter each "Parameter" as specked in monitoring requirements of permit.
<br />5. Enter "Sample Measurement" data for each parameter under"Quantirv" and "Quality" in units specified in permit.
<br />"Average" i5 normally arithmetic average (geometric average for bacterial parameters) of all sample measurements
<br />for each parameter obtainec during "Monitoring Per,'od"; "Maximum" and ",bfinirnurn"' are normally extreme high
<br />and low measurements obtained during "Monitoring Period" (Note to municipals with secondary treatment
<br />requirement: Enter 30dav average of sample measurements under "Average," and enter ma+eimum 7-day average
<br />of sample measurements obtdned during monitoring period under "Mazimum.'J
<br />6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" az specified in permit.
<br />7. Under "No Ex" enter ntunber of sample measurments duripg monitoring period that exceed maximum (and/or
<br />minimum or 7-day average t,s approariate) permit requirement far each parameter. If none, enter "0".
<br />8. Enter "Frequency ojAna/ysis" both as "Smnp/e dleasururent" (actual frequency of sampling and analysis used
<br />during monitoring period) wed as "Perrrri! Requirement" specified in permit. (e.g., f?ntcr "Cool," for continuous
<br />monitoring, "I/7" for one day per week, "1 X30" for one day per month, "l i90" for one day per quarter, etc.)
<br />9. Enter "Sample Type" both as "Samp/e dfeasurernen!" (actual sample type used Burin„ monitoring period) and as
<br />"Permit Requirement," (e.g., Enter "Grab" for individual sample, "24HC' for 23-hour composite. "N/A" for
<br />continuous monitoring, etc.)
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />actions taken, and reference each violation by date.
<br />11. >f "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
<br />12. Enter "Name/f'i!!e ojPrincrpal Executive Officer" Hith "Signature ojPrincipn! Exerrrtive Officer ojAutharized
<br />Agent," "Telephone .Number," and "Date" at bottom of farm.,
<br />13. Mail signed Report to Ogee(s) by date(s) specified ire permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Monitoring Report (DMR) form mazy be obtained from O6ice(s)
<br />specified in permit.
<br />Legal Notice
<br />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
<br />result in civil penalties not to exceed 510,000 per day of violation; or m criminal penalties and to exceed x25,000 per day
<br />of violation, or by imprisonment for not more than one year, or by both.
<br />EPA Form 3320-1 (Rev. 08-95)
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