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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, disregazd instruction duetted at entry of that information already
<br />preprinted.
<br />2. Enter "Pennittze Name/Mailing Address (and facility name location, if different)," " Pzrmit Number," and "Dis_Itargz
<br />Number" where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dates beginning and editing "Monitoring Perici"covered by form where indicated.
<br />4. Enter each "Parometzr" as specified in monitoring requirements of permit.
<br />5. Enter "Samplz M~murzmznt"data far each parameter under "quantity"and Qteolity" as specified in permit. 'Av_raga" is
<br />normally arithmetic average (geometric accmge for bacterial parameters) of all simple mcasuremenu for each parameLr
<br />obtained during ";lf.oitoring Pzri,d'; 'S14.ximum" and Miniwum" aze nomoally extreme high and low measurements
<br />obtai,r_d during "tf.nir,.-irti; P~ri;d". (Note to municipals Frith sewndary treatment rcyairement: Winter 30-day ave-eg;.
<br />of ;ample mezsurcm;-sunder "Av.rayz,"and eater maximum 7-day average of sample measurumms obtained du-ing
<br />monitoring period under "~Yfarirrum.")
<br />5. Enter ':°en:rit R~~ui,-eme:u"for each pazametcr under "~untlity~"nod "~iuali0~" as specified in permit.
<br />7. Under ","/•: Tx" cnL-r numbc; of s. -~ple mcasurcmcn' during mor,itcring period that ~::cecd maximum (and/or riinimnm
<br />cr 7-day avcr~c as a;,propriate) permit requirement for each parameter. if Wont, enter "0".
<br />8. Enter "F~e:i,~ •a;,y ojA.ta/~•sis"both 2s ".S~,:r,-!. A~•acurt,;tt,rt" (ach!al frequency of scmpling end 2nelysis used du=,3
<br />monitoring period) and as "Pzr,nit 2 uir~;r. ant" specified in permit. (e.g. Enter "",at,"fur continuous monitori,^,g, "1 /7"
<br />for one day p::r c: celc, "1/30" far one day per month, "1 /90" for one day per quarter, ere.)
<br />9. Enter "Sarnpl_ Typr" botir as "San;rL ,LLueu •enrzut" (acwal sample type used during menitoring period) and as "1'enui!
<br />17.:gttirzrre,rt," (e.g. Enter "Graf" for individual sample, "24f1C" for 24-hour composite, "~V/A" for contincous
<br />monitoring, etc.)
<br />10. !Vherc violations of permit requirmcnts azc reported, attach a brief explanation to describe cause and corrective actions
<br />to be taken, and reference each violation by date.
<br />1 1. If "uo discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
<br />12. Enter "N: mz/TitL of Principal F,.rz„utivz G,fficsr" with "Signature of Prin. ripal Ex.:cutivz Officer of Authorizzd
<br />Agent, ""Telephone Number," and "Data" at bottom of form.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Dischargz M~ttitoring R.sp~rt (DMR) form may be obtained from Offce(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 result in
<br />civil penalties not [o 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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