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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 (or some minor facilities, to I10 hours as an average per response for some major Ltcilities, with a weighted average (or major and minor facilities of 18 hours per response. including time for reuse+ving instructions. searching existing data sources, gathering and maintaining [he 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 Branrh. PM-333. U.S. Environmental Protection .4genry. 401 Al Street, SW, Washington. DC 30460; and to the Office of Information and Regulatory A((airs, Office of Management and Budget. Washington. DC 20503. General Instructions I. I( tinm has been partially completed by preprinting disregard instructions directed a[ entry of that inl'onnation already preprinted. 1. Enter ~~Perrnittee Name/Mailing Address (:mil faciliq- name/location. d different)." "Permit Number." and "Discharge Number" where indicated. (A separate farm is reyuired for each discharge.) 3. Enter dates begin nine and Coding "h9onirnring Period` covered by form where indicated. 4. Enter each "Paramrte(~ ns specified in monitoring requirements of permit. ~. Enter ".Sample Measurement" data for each pa r:uneter under 'Quantit r' and ""Qualm" in units specified in permit. "Average" is normally nnthme(ic average (eeomet tic average Io: bacterial parameters) of all sample measurements for Cach parameter obtained d~.uing "Afonitoring Period`: `Ma.xinuun~' and "A4inimum" are nonn;dly extreme high and low measurements otnained during "iNonitoring Period: INute to municipals with secondary treatment requirement Enter 30-day average of sample measurements under 'Average.' and inter nutximum 7-day average of sample measurements obtained During nxmi u,n ng period under "Masimuni-1 G. Enter "Permit Reyuirement` for each parameter under "Qu:mtily` ^nd "Quality` as specified in permit. 7. Under `No E.r" enter number of sample measurements durine monitorine period that exceed maxinwnt (and; ur minimum or 7-day average as appropriate) permit reyui rement for each parameter. If none, enter "0". S. Enter "Freyuene:v of Analysis" both as "Sample Measurement"' (actual Irequency of sampling and analysis used during monitoring period) sod us -Pennir Reyuirement- specified in permit. (e.g.. Enter "Cont." for continuous monitoring. "!/7" for one day per week, `1/,70" for one day' per month, "1/9U" for one day per quarter, etc.) 9. Enter `Sample Tvpr" both os "Sample A/easurernent` (actual sample type used during monitoring period) and as -Permit Requirement." (c.g.. Enter "Grab" for i~dicidual sample. `2dHC" for 2d-hour Composite, "N/;4` for con- tinuous monitoring, etc.) 10. \4here violations nl perms requirements are reported. attach a brief ex planntirm to describe cause and corrective actions taken. and reference each violation by date. I I. If "no discharge occurs during monitoring period. enter "fib Discharge" across form in place of data entry. 13. Enter -Nmne,~Title nl Principal Executive O%ficrr" with "Signa(ure of Pnncrpal E'.uecutive Officer of .4utharized Agent,' 'Telephrme Number,- and `Date- at bottom of form. I ~. Mail signed Report to OII ice(s) b}' date(s) specified in permit. Retain copy for your records. la. More drtailed instructions for use of this Discharge Monitorine Repot[ IDMR) form may be obtained from Of- fice(s) ~pecif ied in permit. Legal Notice This report is required by law (33 U.SC. 1318; 40 C.F.R. I?527). Failure to report ur failure to report truthfully can result in civil penalties not «i exceed $10.000 per day of violation: or in criminal penalties not to exceed $25.000 per dap of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-I (Rev. q-RRl