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Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an
<br />average per response for some minor facilities, to 110 hours as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 hours per response, including time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information, including suggestion for reducing this burden, to
<br />Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially completed by preprinting, disregard instruction directed at entry of that information aUeady
<br />Preprinted.
<br />2. Enter "Permittee Nome/Muiling Addrass (and facility nameAocation, if different)," " Pemmi! Numher," and "Gischorge
<br />NumEer" where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dates beginning and editing "Monitoring Period"covered by form where indicated.
<br />4. Enter each "Por~metar" as specified in monitoring requirements of permit.
<br />5. 1?nter "S1r,rpL b/_rasuranznr" data for each parameter under "Quantity"and Quality" as specified in permit. Avzr~ree" is
<br />normally arithmetic aeeragc (geamctic average for bacterial parameters) of all sample mcasure~nrnts for each pa,~metcr
<br />obtained during "+Lfo,r!oring Period"; ".l$ni+num" and bfinimum" arc normally extreme high and low measurements
<br />obtained doling ";:;~,ui!•.+~ing Part:,l". (:':ore io municipals with secoadary treatment requirement: ;-Hier 30-day average
<br />of sc~nplc mc=,uremznts under 'Avrrlg,;,"and enter ma.cimum 7-day average oC sar i': measurements cbtaines du ing
<br />monitoring period under "i>,axinttun.")
<br />u. ::ntcr 'P,:n;;i!.~ jt~i+e+nr.t!" fo. each pazamctcr under "Qu~ulih-"aud "Quali(;~"as specified in Fenni~.
<br />7. U~acr "~:'-: cr" D~::r mm~her ofsamplc mcrsurzmznt during monitoring ;_riod L'tat c~caed maximum !rr.d/cr otirmum
<br />cr 7-d y , vc, ,~c as zppraprate) t:;,mit rcquimmcut for each paiarncter. Ifnune, toter "0".
<br />S. ~:n°cr ",~+_•.lr~,+_y %f/in~loc%i"L-o8r ~; 'S.mt t.:Lfs~ertaran" (acl~l f-:cyucrcy a' sampling and analysis ascd durng
<br />nonitorng pcr'od) an:l c..';°=,+,iil p,~luirdnt_n!" spcuined in permit. leg. Enter ":'-,n!,"for continuous meni:oring, "!/7"
<br />fr,r one day p=~ ~: x;:, "1/30" Co one day per month, "1/90" far one day per quarter, etc.)
<br />9. ;'ntcr "J +d1~~7 T~~.n ltai~] u ".S ,+nri. +li r~u,'~l',t 31r!" (CCtt;al samp~C type' 15ed dunng mOmtann~ ^Cn OG) anG as "T_ITd!!
<br />2~ui;:n+,:.r~," (c.g. -Hier "Gr1P" for iodicidusl :ample, "?411" for 24-hour composite, '.V/,i" for con',auous
<br />monitoring, etc.)
<br />10. ~'Iltcr violations of z+~rril re ;uireme~~ts arr reported, attach a hrief e;:planation to dzscr.be c~~se and wrrx,'vc ~.'.;a.~s
<br />to be take r, znd reference each violation by date.
<br />1 ]. li "no d'scharga" occws doing mc::;toring perioc, enter "No Dischazge" across fon-n in place of data enhy.
<br />12. °n'.cr "A!~m~/Ti1L• %f +°~•Lruifa! F.x~~~div: G~~_r" with "Sie~rtatttre of Principal Ex__ulivs O)~~~r ojAurSo,•izrd
<br />dg~nt, ""Talephone NeuaF. er, "and "Date" a[ bottom of form.
<br />13. AQail signed Report to O+Tice(s) by date(s) specified in pcrtni[. Retain copy for your records.
<br />l4. More detailed instructions for use of this Discharge Monitoring Repor! (DMA form may be obtained from Oiiice(s)
<br />specified in permit.
<br />~.egal 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 result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violatio0.
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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