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Paperwork Reduction Act Notice Public reporting burden for dris collection of information is estimated to vary from a range of 10 hours as an Overage per response for some minor facilities, to 110 hours as m average per resZtopse•for some major facilities, weighted average fo[ rmjor and minor facilities of 18 hours per '~ including time for reviewing _taearohing existing data sources, gathering and mainta' - to needed, and completing and 'the collection of information. Send cotntnents regarding; the burden estimate or any other aspcxt of this collection of inforrnatioc., including suggestions for reducing this burden, to Chief, lnformatioo Policy Branch, PM-223; iJ.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 Instructior~ =' ]. If form has been partial{y completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter "Permirtee Name%LJailing Address (and facility name/4ocation, if di5'eren[)," "Permit Number," and "Discharge Namber" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'iLlonitoring Period" rnvered by form where indicated. 4: Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample MeasuremenP' data for each parameter under "Qunnti(v" and "Qaalily' in units specified in permit. "Average" is normally aritl.metic avemge (geometric average for bacterial parameters) of all sample measurements for each parameter obtainei during "Aonitoring Period'; "Mgxinrunt" and "Minimum" are normally ea~treme high and low measurements obtained during "Monitoring Period." (Note to municipals with secondary treatment requiretmnt: Enter 30-day average of sample measuuments under "Average," and enter maximum 7-day average otsample measurements obtained during monitoring period under "Maximum.') 6. Enter "Permit Requtremenr" for each parameter under "Quantity" ~md "Quality" as specified in permit. 7. Under "No Ex" enter number of sample measurments during moniroring period that exceed maximum (and/or minimum or 7~ay average es appropriate) permit requirement for each parameter. E none, enter "0". 8. Enter "Frequenev ojAnal~~.ci.s" both as "Sanp/e Afeasurntent" (actual frequency of sampling and analysis used during monitoring period} and as "Permit Requirement" specified in permit. (e.g , Emer "Cons," for continuous monitoring, "//7" for one dvy per week, "//30" for one day per month, "J/90" for one day per quarter; etc.j 9, Enter "Sample Tvpe" both as "Sample Measurement" (actual sample type used during monitoring period) and as "Fermi! Requirement," (e.g., Enter "Grab" for individual sample, "2dHC""' for 24-hour contposile, "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 refere»ce each violation by date. 11. U "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name//'itle ujPrincipal Executive Officer" with "S'ignalure ojPrincipal Executive Officer ajAvthorized Agent," "Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in perntit. Retain copy for your records. 14. M1tore detailed instructions for use of [his Discharge Monitoring Report (DMR) form m:ty be obtained from Offce(s) specified in permit. Legal Notice This report is required by taw (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in civil penalties tmt to exceed a 10,1)00 per day of violation; or in criminal penalties eat to exceed $25,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. OS-95)