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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 m average per response for some minor facilities, to 110 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, searching existing data sources, 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-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. General Instructions 1. If form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter "Permittee .Name/Mai/ing Address (and facility namellocation, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending "Afonitaring Period" covered by form where indicated. 4. Enter each "Porarnerer" as specified in monitoring requirements of permit. 5. Enter "Sample ,t'feasurement" data for each parameter under "Quantity" and "Qvalin~" in units specited in permit. "Average" is normally arithmetic average (gcorncuic average for bacterial parameters) of all sample measurements for each parameter obtained during "dlonimring Period'; ".tfazimum" and "dlinimvm" are normally extreme high and IoH~ measurements obtained during ".llanitoring Permd." (Vote to municipals with secondary treatment requiremenC Enter 30-day average of sample me~•surcmcnis under "Averoge;' and enter maximum 7-day average of sample measurements obtained during monitoring period under ",[foxirnum.'J 6. Enter "Permit Requirement" for each parameter under "Qunnriry" and 'Quality" as specified in permit. 7. Under "No Er" enter number of sample measurments during monitoring period [tuff exceed maximum (and/or minimum or 7-day average az appropriate) perntit requirement for each parameter. If none, enter "0". 8. Enter "Frequency ojAnalysis" both az "Sample b/ea.rurnrent" (actual frequency of sampling and analysis trsed during monitoring period) and az "Fermi! Requirement" specified in permit. (e.g., Enter "Cons," for continuous monitoring, "1/T' for one day per week, "1/30" Cor one day per moot}[, "1190" for one day per quarter, etc.) 9. Enter ".Sample Type" both az "Sample ;bleasurement" (actual sample type used during monitoring period) and az "Permit Requirement," (e.g., Enter "Groh" fir indisidual sample, "7~JHC"' for 24-hour composite, ",V/A" 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 b}• date. 1 I. If "no discharge" occurs during monitoring peri~rd, enter ".No Discharge" across form in place of data entry. 12. Enter ".Name/!irle ojPrimcipa! Fxeculive O~~:er" µith "Signature ojPrincipn! Executive Officer ojAuthorized Agent," "Telephone Number," and "Date" at bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy Cor your records. 14. More detailed instructions for use of this Dischcrge Afoniroring Report (DMR) form may be obtained from Office(s) specified in permit. Legal Notice This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in civil-penalties not to exceed a 10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. 08-95)