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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 average per response for somr, minor facilities, to i10 hours as an average per response for some major facilities, with a weig~ted average for major and minor facilities of l8 hours per response, including time for reviewing insructions, searching ezisthrg data sott[cea;.~thering and maintaining the data needed, and completing and reviewing the collection of information... 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. Envimnmental Protection Agency, 401 M Street, SW Washington, DC 20460; and to the Office of Informttibn and ReZvlatory A`fairs, Office of Management and Budget, Washington, DC 20503. General Instructions 1. If form has been partially completed by preprinting, disregazd instructions directed at entry of that information already preprinted. 2. Enter "Permittee NameQ~lailing Address (and facility nameJloration, if different)," "Permit Number," and "Discharge Number" wher: indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'Afonitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample Afeasurentent" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normal:}' arithmetic average (geometric average for bacterial parameters) of all sample measurements (or each pazameter obtained during "A4onitoring Period"; "Maxirrturn" and "Afinimum" are normalty extreme high and low measuremctris o~tained during "Afoniroring Period." (Note to municipals with secondary vestment requirement: Enter 30-da; avemge of sample measmements under "Average," and enter maximum ?clay average of sample measurements oht:r;ned during monitoring period under ".Maximum. 6. Enter "Permit Requiremen"' for each parameter under "Quantity" and "Quality" as specified in permit. 7. Under "A'n Ex" enter muiber of sample mcasunnents during monitoring period that exceed maximum (and/or minimum or 7-day average as approariale) permit requirement for each parameter. If none, enter "0". 8. Enter "Frequrncy ojAna,ysis" bath as ".Sample A/easunnenr" (actual frequency of sampling and analysis used during monitoring period) and as "Permrt Hequiremenr" specified in permit (e.g., Enter "Conn," fur continuous monitoring, "//7" for one cay per week, "! X30" for one day per month, "I%90" for one day per quarter, e[cJ 9. Enter "Sample Type" both as "Sample .lleosurement" (actual sample type used during monitoring penod) and as "Penmt Requirement," (e.g., Enter "Grab" for individual sample, "24HC" for 24-hour composite, "NiA" for continuous monitoring, etc.) 10. Where violatiotu of pernut requirements are reported, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. 1 I. U "no discharge" occurs doing monitoring period, enter "No Discharge" across form in place of data entry. l2. Enter "Name/title ojPrincipal Executive Officer" with "Signature ojPrincipal Executive Officer oJ.4ulhorized ,4gent," "Telephone Number," and "Date" at bottom of form. • 13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records. 14. More detailed instructions for use of this Discharge Afonitoring Report (DNIRJ form may be obtained from OfLce(s) specified in permit. Legal Notice This report is reouirecl b~~ law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result m civil penalties not [o excxd S 10,000 per day of violation; or in cnminal penalties not to exceed $25,000 per day of vtolatioo, or by imprisonment for not more than one year, or by both. EYA Farm 3320-1 (Rev. 08-95}