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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 tune 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 />I. If forth has been partially completed by preprinting, disregard instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Permittee Name/1lfailing Address (and facility name/location, if different)," "Permit Number," and "Discharge
<br />Number" where indicated. (A sepazate form is required for each dschazge.)
<br />3. Enter dates beginning and editing "Monitoring Fzriod"covered by form where indicated
<br />4. Enter each 'Paramztzr" as specified in monitoring requirements of permit.
<br />5. Enter "SomFlz hL•asurzr.:en!"dsta for each parameter under "Quanti.ry"and QaaliJ~~"as specified in permit. 'Avsr~oz" is
<br />normally ttithmetic average (geometric average Tor bacterial parameters) oC all sample mcasutements for each parameter
<br />obtained during ",L1,nitoring Pzr•i~d'; "do'.trinuun" and ~Lfininuun" am oormaliy extn:ne high and low mcasur:mcmt,
<br />obtained during ",L;:uitorirtg °:ri ./". (Note to municipals a~itit secondary treatmer[ requirement Loter 30~ay average
<br />of sample mexsurerr cols under 'Avzragz,"and enter maximum 7-day average of sar.~pl.: measuremems obtained dutitg
<br />monitoring period under "ivfaximum.")
<br />G. Enter "Prrneit ~~ fnir:mznt"for each parameter undrr "Q+r +ntit)+" and "Qaality" as s; ecified in permit.
<br />7. undrr "A~o G~' e1:cr number of sample mcasur.:mcmt during monitoring period thcl c.c~;ed :raximunt (and/or ~ni,~ mum
<br />or 7-day aceragc as a;,propriate) permit requirement for each parameter. If none, enter "0".
<br />8. ~r'.r ",^rt°qv ~n_y :jL+ral~sis" boot as "SamFL :YL_+surv_mu:!" (ach!ai f :eucccy ui sampling and analysis used de+;no
<br />~nmi,itoring per, cud) and as "Pzrrrit 27uir-znuu!"specified in pcnnii (e.g. °ntcr "Ccr+l," roe eonLnuous monitoring, "I/7"
<br />cur one day per treclc, "1/30" Tr one day per moatii, "Ii90" for one day per quarter, etc
<br />S. Fntcr S~nr! Iz TyFz" ba'.h as S~.nF!z rif_•ast.,zma7t"(actual sample type used durinb monitoring p: rind) and as "P~rmir
<br />R~yuirzms,e." (c.g. Enter "vr~c" for individual sample, "24HC" fur 24-hour composite, 'SV/A" for continuous
<br />monitoring, etc.)
<br />10. ~r.'here triol~tions of peer[ requirements are reported, attach a brief explanation to deseilte cause and corrective actions
<br />to be taken, and refercoce each violation by date.
<br />11. if"no dsc4arge" occws during monitoring peried, enter "No Dischage" across form i^ place oTdata entry.
<br />12. Enter "Namz/Tidz of Principal Fri utivz ~~~r" with "Sib~r_+ture of PrinciF~l Er3LT!l/V3 O~~zr of Anth~.riud
<br />Atiznt, "'Tzlep:rcnz NwnEzr,"and 'Date" at bottom of form.
<br />13. Mail signed Report [o OFiice(s) by date(s) specified io permit. Retain copy far your records.
<br />14. More detailed instructions for use of this Discharge Monitoring 2por7 (Dl~tl~ form may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />This repoR 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 violation,
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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