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Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as art average per response for some minor facilities, to 110 hours as an average per response for some major facilities, with a weighted average for major and minor facilities of 18 hours per response, including tir^.e for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information, including suggestion for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protectio^ Agency, 407 :~I Street, S.~\r. Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of i!r"anageatent and Budget, Washington, DC 20503. A T _ !!qq~~~~'' C 5 l~~f ...J/.. 1. If Forth has been partially completed by preprinting, disregazd instruction directed at entry of that infortnction already preprinted. 2. Enter "Pzrmittee Name/Mailing Address (and facility name/location, if different)," " Pern[i[ Nz•rl•~r," and "Cischu,bz Number' where indicated. (A separate forty is required for each discharge.) 3. Enter dates beginning and editing "Monitoring Period" covered by form where indicate. 4. Entet each 'Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample Mzosurzment"data for each .parameter under "Quantity" aid Quality" as specified in pe.-rrit. "Av.' -ag ~" is normally arithmetic average (geometric avc-age for bacterial pazameters) of all sample measuremcnt~ :cr eac i parnmaer obtained during "Monitoring Period'; "d;,ximum" anL Idinimum" aze normally extreme high and lov+ mcasu ements obtained during "Monitoring Period". (Note to municipals with secondary treatment rcgairemenl: ='rtcr 30-day average of sample measurements under 'Average,"and enter maximum 7-day average of sample measurer =nts obt-inec during monitoring period under "Maximum. ") 6. Enter "Permit 2quirement"for each parameter under "Quantity"and "Quality" as speci Sed i^ perry :. 7. Under "No Ex' enter number of sample measurement during monitoring period that exceed maximmr t (anu x m nimum or 7-day average as appropriate) permit requvement for each parameter. [f none, enter "0". 8. Enter "Frequency ojAnalysis" both as "Sample Meosurznrznt" (actual frequency of sampling and analysis tsed during monitoring period) and as "Permit Requirer,rent" specified in permit. (e.g. Enter "Coat," for continuous moni',orirg, "I/7" for one day per week, "1/30" far one day per month, "1/90" for one day per quarter, etc.) 9. Enter 'Sample Type" both as "Samplz Meosrnnment" (actual sample type used durimg monitoring p~; i ~d) and as 'Permit Requirzmznt," (e.g. Enter "Grab" for individual sample, "247iC" far 24-hour composite, 'S\rGt" for CO+l:wu0us monitoring, etc.) 10. Where violations of permit requvements arc reported, attach a brief explanation to describe cause znd comactive actions to be taken, and reference each violation by date. 11. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. 12. Enter "Name/Ti[lz of Principal Executive OfJFczr" with "Signature of Principal Executive Offi.~zr of Authorized Agent, ""Telephone Number,"and "Date" at bottom of form. 13. Mai] signed Report [o Office(s) by date(s) specified in permit. Retain copy for your r~co -ds. 14. More detailed instructions for use of this Uischargz Monitoring Report (DMI~ foam may be obt~ired from CfFice(s) specified in permit. Legal 1VT~tice This report is required bylaw (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report tr~th!'ully can result ir. civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to cxceed $25,000 per day of violation, or by imprisonment for not more than one yeaz, or both.. EPA Form 3320.7 (Rev. 03/99)