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PaperworI~ Reduction A~~lotice Public reporting burden for tlB~eollection of information is estimated to vary from a range of 10 hours as an average per response for somr, ~ facilities, to 110 hours as m average per response for some major facilities, with a weighted average for major and minor facilities of 18 hours per response, including time (or reviewing instructions, searching existutg data sourc;s,~athering end maintaining the da~a aeeded, and completing and reviewing the collection of irtfortna[ion. S ~ nts r~[rding the burden estimate or any other aspect of this collection of information, including Bugg " fG~.'jpducmg this burden, [o ChieF, information Policy Branch, PM-223, U.S. Environmental Protection 1~q{'1~I F/i Street, SW Washington, DC 20460; end to the Office of Information aad Regulatory Affairs, Office 6f I4Iaaagement and Budget, Washington, DC 20503. ,~. General Ynstructions 1. If form hu brgln partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. Z: Enter 'Permittee Name/l~ailing Address (and facility namellocation, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required Cor each discharge) " 3. Enter dates beginning and ending 'Monitoring Period" covered by form where indicated. 4. Emer each "Parameter" as specified in monitoring requirements of perntit. 5. Enter "Sample Mensurement" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normally arithmetic average (geometric average for bacterial pazameters) of all sample measurements for each parameter obtained during "Monitoring Period"; "hlazimum" and "Alinimum" are normally extreme high and low measurements oaained during "Monitoring Period." (Hole to municipals with sewndary treatment requirement: Enter 30-da:~ average of sample measurements under "Average," and enter maximum ?may average of sample measurements obtained during monitoring period under "bfacimum. ") 6. Enter "Permit Regairemen"' for each parameter under "Quantity" and "Quality" as specified in permit. 7. Under "h'o Er" enter nunber of sample measurments during monitoring period that exceed maximum (and/or minimum or 7~ay average as appropriate) permit requirement for each parameter. if none, enter "0". B. Enter "Frequency nj Ana. µcis" both as "Sample bleasurmen!" (actual frequency of sampling and analysis used during monitoring pcriod)~and as "Permit Requirement" specified in permit. (e: g., Enter "Cant," for continuous monitoring, "!i7" for one cay per week, "1,30" for one day per month, "I/90" for one day per quarter, etc.) 9. Enter "Sample Ttpe" both as "Sample Aleasurement" (actual sample type used during monitoring period) and as "Permit Requirement," (e.g., Enter "Grab" for individual sample, "2JNC" for 24-hour composite, "NiA" 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 entry. 12. Enter "Name/Title ojPrincipa! Executive Officer" with "Signature ojPrincipal Executive Officer ojAu(horized Agent," "Te!ephane Number," and "Date" at bottom of form. 13. Mail srgned Repon [o Office(s) by date(s) specified in permit. Retain copy for your records. 14. More detailed insWCtioas for use of this Discharge Afoni7oring Report (DA1RJ form may be obtained Gam Ollice(s) specified in permit. Legal Notice T3vs report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure [o report or failure to report truthfully can result is civil penalties net to ezcxd S 10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation, or by imprisottment for no[ more then one year, or by both. EYA Forw 3.320-1 (Rev, OB-95)