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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated [o vary from a range of 10 hours as an average per response fur 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 lime for reviewing instructions, seuching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of infortvation. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Chief, Information Policy Branch, PM-223, U.S. Environmental Protution Agency, 401 M Street, SW Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. General Instructions I. If form has been partially completed by preprinting, disregard instructions directed at entry of that information :.already preprinted. 2. Enter 'Permittee Nonre/Afahng Address (and facility name location, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending ';Monitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample rtifea.,wemenP' data for each parameter under "Quantity" arrd "Quality" in units specified in perm[. "Average" is normally arithmetic avenge (geometric average for bacterial parameters) o(all sample measurements for each parameter obtained during ":tfonirnring Period'; "Maximum" and ".4/ininrunr" are normally eztrente high and low measurements obtained during ".lonitoring Period." (Note to municipals with secondary treatment requirement Enter 30-dav average of s:unple measurements under "Average," and enter maximum 7<iay average of sample measurements obtained during monitoring period under "blazimr.,n. J 6. Enter "Permit RequrremenP' for each parameter under "Quantity" and "Quality" az specdied in permit. 7. Under "No £x" enter number of sample meazurmen[s during monitoring period that exceed maximum (and/or minimum or 7-day average az appropriate) permit requirement for each parameter If none, enter "0". 8. Enter "Frequency of Analysis" both us "Sample MeasunnenP' (actual frcquenry of sampling and analysis used during monitoring period) and az "Pe-nit Requir•err+ent" specified in pernrit. (e.g., Enter "Cons," for continuous monitoring, "!/7" for one da}• per week. "I.'JO" for one day per month, "//9C" for one day per quarter. etc.) 9. Enter ".Sample Type" both 2s "Sample Aleasvrcrnent" (actual sample type used during monitoring period) and az "Permit Requirement," (e.g., Lmer "Grab" for individual sample, "2dfIC" for 24-hour composite, "h-:4" for continuous monitoring, etc.) 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. 11. if "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entr}•. 12. Enter "Name/I'itle ojPrincipai Executive Officer" with "Signature ojPrincipal Executive Officer ojAuthorized Agent," "Telephone Number," and "Date" al bottom of form. 13. Mail signed Report to Office(s) by datets) specified in pernit. Retain copy for your records. 14. More detailed instructions for use of this Discharge Monitoring Report (DrL/R) form may be obtained from Office(s) specified in permit. Legal Notice This report is required by iaw (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 x10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. 08-95)