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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 an average per response for some minor facilities, to 110 hours ru an averege per response for some major facilities, with a weighted average far major.and minor_facjlities of 18 bouts per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing end reviewing the collection of information. Send comments regarding. the burdeaestimate or any.olheraspect of this collection of information, including suggestions for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Envirorunental Protection Agency, 401 M Street, SW Washington, DC 20460; end So the Office of Information and Regulatory Affairs, Office of Managerttent aad Budgeter Washington, DC20503: '' ~eneralInstructions - _ I. If form has been partially completed by preprinting, disregard insttuctionsdirected at entry of that information already preprinted. --- -- -- .-_ ._. _ . -- _ 2. Enter "Permiltee Nanre/A-failing Address (and facility hame/localion, if different)," "Permit Nlrnrber," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending il~onitdring Period" covered by form where indicated. 4. Enter each "Parameter" az specked in monitoring requireroents of permit. 5. Enter "Sample Nfeasuremeru" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally aritfinetic average.(geomelric average for bacterial parameters) of all sample measurements for each parameter obtained during "Monitoring Period'; "Afaxinrum" and "Minimum" are normally extreme high and low measurements obtained during ",tonitoring Period." (Note to municipals with secondary treatment requirement: Enter 30-day average of sample meazurements under "Average," and enter maximum 7~day average of sample measurements obtained during monitoring period under "Maximum. 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" az specified in permit. 7. Under "No Er" enter number of sample measurments during monitoring period that exceed maximtrm (and/or minimum or 7-0ay average az appropriate) permit requirement for each parameter. >f none, ehter "0". 8. Enter "Frequency of Analysis" both. as "Sample Measurment" (actual frequency of sampling and analysis used during monitoring penod) and az "Permit Requirenren!" specified in permit. (e.g., Enter "Coot," for continuous monitoring, "//7" for one day per week, "f/30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Type" both az "Sample Measurement" (actual sample type used during monitoring period) and az "Pernrit Requirement," jp.g.,'$itter "Grab" for individual sample, :4HC' for 24-hour composite, "N/A" for continuous monitoring, dtc.) 10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. I1. If "oo discharge" occurs during monitoring period, enter "No Discharge" across (ono in place of data entry. 12. Enter "Name/fi!le ojPrincipal Executive OJTcer" with "Signature ojPrincipa! Executive O]Tcer ojAuthorized Agent," "Telephone Number," and "Date" at bottdm of form. 13. Mail signed Report to OBice(s) by date(s) specified in permit. Retain copy for your records. 14. More detailed instructions for use of this Discharge tifoniroring Report (DMRJ form may be obtained from Office(s) specified in pennil. 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 S2S,ooo per day of violation, or by imprisonment for not more than one year, or by both. ,.. EPA Form 3320-1 (Rev. 08-95)