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Paperwork Reduction Act Notice Puhlic reporting burden for this collection of information is estinnuzd [o vary from a range of 10 hours as an average per response for some minor facilities, to I10 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 time for reviewing instructions. starching exis[ine data sourczs. gathering and maintaining the data needed. and completing and reviewing the collection of information. 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-?33, U.S. Environmental Protection Agency. 401 M Street. SW, Washington. DC ?0460: and to the Office of Information and Regulatory Affairs, Office of Munagemznt and Budget. Washington. DC 20503. General Instructions I. II' form h:u been partially completed by preprinting. disregard instYUCtions directed at entry of that information already preprinted. ?. Enter 'Penniuer NamriMaihng .Address (and facility name/location. if dif(erent),~' "Permit Number." and "Discharge Number" where indicated. (.A separate form is required for each discharge.) 3. Enter (sates beginnine and ending'Aionrroring Period" covered by form where indicated. 4. Enter each `Paramrrer" as specified in monitoring requirements of permit. i. Entry "S:unplr Measu cement" data Ibr each parameter under "Quantity" and "~Qualirr" in units specified in permit. "Arerrgr" is normally arithmetic average (geometric avenge for bacterial parameters) of all sample measurements for each parameter obtained durine "Moni(nring PerioJ': `kla.xinunn` and "Minimum" art normally extreme high and low measurements obtained during ':~Noni(onng Perod.- INbte to municipals with secondary treatment requirement: Emer 30-day average of sample measurements under "'Avermge." and toter maximum 7-dac average of sa rnple measu rentents obtained during monitoring period under "b1asimum:) 6. Enter "Permit Requirement' for each parameter under "Qu:mli(t'' and "'Qualirp` as specified in permit. 7. Under "Nn £a" corer number of s;unple measurements during monitorine period Chef exceed maximum (and/or minimum or 7-day average as appropriate) permit requirement for each pa ramerer. I( none, enter '(1`. ti. Enter "Frequency n!' .Analysis' both as "Smnple MeasuremenC' (actual frequency of sampling and analysis used during monitoring period) and as "Permit Requirement- specified m perms). (e.g., Enter "Cunt- for continuous monitoring. "l,~7" for one day per wee4„'/: ~0' for one day per month, '1;90` for mte day per quarter, etc.) 9. Enter `Sample Typr"-hoth as "S:unple M1lrasurernenr` (actual sample type used during monitoring period) and as `Pernrir Rrquiremenc' (r.g.. Enter "Grab" for individual sample. 7dNC' I'or 24-hour composite, 'N,iA" I'or con- tinuous moni[orin_, etc.) ' 10. \4here ciolntions of permit requiremzn[s are reported, attach a brie) explanation to describe cause and corrective nctiuns taken. and reference each violation by date. I I. If "no discha tee" nccurn during monitoring period. enter "Nn Discharge" across form in place of Jma entry. 12. Enter "Name,%Title n( Principal Errcuuvr O(I'rcrr" with "Signature of Principal E,cecutire Officer of AurhorizeJ agent," "Tr/rphane .^+'umbrr." and 'Darr` at bottom of form. I3. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records. Id. More detailed mstnictions for use of this Discharge A9onitorinc Rrprn'r (DM R1 form may be obtained from 01=. f ice(s) specs( ieJ in permit. Legal Notice (his report is required by law (33 U.S.C. IJIR; 40 C.F.R. I'_5.?71. Failure to report ur failure m report tnnhliilly can restd[ in civil penalties not to exceed $10.000 per day of violation or in Criminal penalties not to exceed $25.000 per d:+p of violation. or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. 9-88)