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1<'aperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as as average per response for Borne 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 lime for reviewing instructions, searching ezisi.ing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding [he 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. Env.ronmeotal Protection Agenc}'. 401 M Street, SW Washington, DC 20460; and to the Office of Information and Regulatory Affairs, O(tice of Management and Budget, Washington, DC 20503. General Instructions 1. If form has been partially completed by preprinting, disregard instructions directed et entry of that information already preprinted. 2. inter "Pergtittee ,Vnrne,:Llmhng .9ddress (and facility name/loeation, if different)," "Permit Number," and "Discharge Number" wh~:re indicated. (A separate form is required for each discharge) 3. Enter dates beginning and coding ".tlonitnring Period" coeered by form where indicated 4. Enter each "Parornerer" :rs specified in monitoring requirements of permit. 5. Enter ".Cample dfeasurernmr" data for each parameter under "Qunnnty" and "Uunlt(v" in units specified in permit. "Avernge" is norntallc arithmetic average (geometric average far bacterial parameters) of atl sample measurements for each parameter obtained during ".tfonrroring Period"; "9lnznnuur" and ",lfinimurn" are normally extreme high and low melsurcmcnts obtained during "Slonitr~ring Perod." (Note m municipals with secondan treatment requirement Enter l0-tlac average of sample measurements under ".4vernge." and enter maximum 7~a} average of sample measuremcros obtained during monnoring period under ".lfaxunvrn. "J 6. Enter "Yermir Requirernenr" for each parameter under "Quantity" and "Quo6h" as specified in permit. 7. Under ",Vo Es" enter nlmbcr of s:rmptc measurments during monitoring period that exceed maximum (and/or minimum or 7-dac a~crage as appropriate) permit requirement Cor each parameter. If none, enter "0". 8. Enter "Frequenn• rjArnlv.rrs" both as ".Cnrnple Aleasunnenl" (actual Crequcnc} of sampling and analysis used during monitoring period) and as "Penmr Requirement" specified in permit. (e.g.. Enter "Cont." for continuous monitoring, "1 7" for onr. day per week, "/ •?0" Cor one day per month, "h'90" for one day per quarter, etc.) 9. Enter ".Sample Type" bath as "Sample !.Icosuremen!" (actual sample tvpe used during monitoring period) and as "Permit Requirement," (c.g., Enter "Grab" for individual sample, "?aHl"' for 24-hour rnmposite. "N!4" for continuous monitoring, etc. ) 10. Where violations of pernrl requirements are reported, attach a brief explanalion to describe cause and corrective actions taken, and reference each violation by date. I I. If "no discharge" occurs during monitoring period, enter ",ti'o Discharge" across form in place of data entry. 12. Enter "Name/f'itle ojPrincipal Executive Officer" with "Signature ojPrincipn/ Executive Officer oJ.authorized Agent," "Telephone Number," and "Dare" at bottom oCform. 13. Mail signed Report to O13ice(s) by date(s) specified in permit. Retain copy for your records. l4. More detailed insrructions for use of this Discharge Afoniloring Report (DAfRJ 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 510,000 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. E.PA Form 3320-1 ('Rev. OS-9!i)