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Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated [o vary from a range of 10 hours as an average per response for some minor facilities, to 110 hours as an average par 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 [he collection of information. Send comments regarding the burden estimate or any other aspect of this collection of imforma[ion, including suggestions for reducing this burden, to Chief, Lmformatioo 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 I. if form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter "Permrt[ee A'ame%L1niling Address (and facility name location, if different)," "Perini! Nwnber," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending "hloniroring Period" co~2red by form where indicated. 4. Enter each "Paraneetei' as specified in monitoring requirements of permit. 5. Enter "Sample Aleasuremem" data for each parameter under "Quantity" and "Quality" in units specified in permit. "Average" is normaly arithmetic average (geometnc average for bacteria: parameters) of all sample measurements for each parameter obtained during ",1lonironng Period"; ".1laximum" and ",llinimmn" are normally extreme high and low measurements obtained dunng ".tlmnitonng Perwd." (Vale to municipals with secondary [tea tin en[ requirement: Enter JO-day average of samptc :ucasurcments under "Average," and enter maximum 7~ay a+rerage of sample measurements obtained during monitoring period under ",Ilarimum.') 6. Enter "Permit RequircmenP' for each parametct under "Quantity" and "Quality" as spectfied in permit. 7. Under "No Ex" enter number mf sample measurments during monitoring period that exceed maximum (and/or minimum or 7-da} average as appropriate) permit requirement for each parameter. [f none, enter "0". 8. Enter "Frequency oj.-0nalysis" both as "Sample .1leasurment" (actual frequenn• of sampling and analysis used during monitoring period) and as "Permit Reeuireurenr" specified ;n pcrrut. (e. g., En[cr "Con(," for continuous monitoring, "1/7" for one day per week, "1'30" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Ttipe" both as "Sample .tlrosureinent" (actual sample type used during monitoring period) znd as "Permit Regvirernent," (e.g., Enter "Grab" (or individual sample. "1d1/C"' for 24-hour composite, ";~'~A" for continuous monitoring, etc.) 10. Where violations of permit requirements are rcponed, attach a brief explanation to describe cause and coreclive actions taken, and reference each violation by date. 11. ll "no discharge" occurs during monitoring period, enter ",'Va Discharge" across form in place of data entry. 12. Enter "Name/!'i1/e ojPrincipa! Executive O~rer" With "Signature ojPrincipa! Executive Officer ojAufharized Agent," "Telephone Number," and "Dare" al bottom of form. 13. Mail signed Report to Office(s) by date(s) specified in pemtit. Retain copy for your records. 14. More detailed instructions for use of this Discharge Alonitoring Repot! (D.L1R) form may be obtained from Office(s) specified in permit. Legal Notice This report is required by law (33 U.S.C. 1318; 40 ('. F. R. 125.27). Failure to report or failure to report truthfully can result in civil penalties not to exceed S 10,000 per day of violation; or in criminal penalties not to exceed x25,000 per day of violation, ar by imprisonment for not more than one year, or by both. EPA Form 3320-1 (Rev. 08-95) r