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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an t+verage per respotse for some minor facilities, to 110 hours as an average per response for some tmjor facilities, with a weighted overage for major and minor facilities of 18 hours per response, including time for reviewing instructions, searching exrstirg data sources, gathering aad mairnaining the data needed, and completing and reviewing the collection of reformation. Send comments re)~rdiag the burden estimate or any other aspect of this collection of informatior , including suggestions for .teduc"mg this burden, to Chief, Information Policy Branch, PM-223, U.S. Envirenmeotal Protection Agency, 401 M Street, SW Washington, DC 20460; aad to the Office of Information and Regulatory Affairs, Office of Managerttent and Budget, Washington, DC 20503. General Instructions 1. If form has been partially completed by preprinting, disregard instructions directed at entry of that inforrmlion already preprinted. 2. Enter 'Permittee Name/1t1ailing Address (and facility ttamellocaUot4 if different)," "Permit Number," and "Discharge Number" where indicated. (A sepazate form is required for each discharge.) 3. Enter dates beginning and ending 'itlonftoring Period" covered by form where indicated. 4. Enter each "Parameter" as ;pecified in monitoring requirements of permit. 5. Enter "Sample Measurement" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally aria merit average (geometric average for bacterial parameters) of all sample measurements far each patzme[er obtainoi during "Monitoring Period"; ".4faximunr" and "Afininr:nrr" are normally estrcme high and low measurements obtained during ",4foniforrng Period." (Note to municipals w~ih secondary treatment requirement: Enter 30-day average of sample measurements under "Average," and enter maeimum 7-day average of sample measurements obtained during monitoring period under "Afaximum. 6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" as specified in permit. 7. Under "No Ex" enter number of sample measurments during monitoring period that ecceed maximum (and/or minimum or 7-0ay :overage as appropriate) permit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnalvsis" both as ".Snmp/e Afeasurnrent" (actual frequency of sampling and analysis used during monitoring penod) and as "Pernrir Requireu:enr" specsed in permit. (e.g , Enter "Cons," for continuous monitoring, "//7" for one day per week, "1/30" for one day per month, "//90" for one day per quarter, etc.) 9. Enter "5'anrp/e Tvpe" both as "Sample tifeasurenrenr" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for indn~dual sample, "?4IfC" for 24-hour composite, "N/A" for continuous monitoring, etc.) 10. Where violations of permit requirements are reported, attach a brief e.~planation to describe cause and corrective actions taken, and reference each violation by date. 1 I. If "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. l2. Enter "Name/ftffe ojPrtacipal Executive O~cer" with "Signa(ure ojPrincipa! Executive Ojrcer ojAuthorized Agent," "Telephone Number," and "Date" at bottom of form. ] 3. Mail signed Report to Otlice(s) by date(s). specified in permit. Retain copy for your records. 14. More detailed instructions for use of this Discharge hfonitoring Report (Dh1R) form may be obtained front Office(s) specified in permit. Legal Notice This report is regttiretl by law (33 U.S.C. ]318; 40 C.E.R. 125.27). Failure to report or failure to report truthfully can result in civil penalties not [o exce<~ 510,000 per day of violation; or in criminal penalties not to excead $25,000 per day of violation, o: by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rer•. 08-95)