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Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an
<br />average per response for some minor facilities, to 110 hours as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 hours per response, including time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information, including suggestion for reducing this burden, to
<br />Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information already
<br />preprinted.
<br />2. Eater "Permittee Name/Mailing Address (and facility name/location, if different)," "Permit NumL~r," and "Discharga
<br />Number" where indicated. (A separate form is required for each discbazge.)
<br />3. Enter dates beginning and editing "Nlonitor•ing Ferio.~"covered by form where indicated.
<br />4. Enter each "Paromerzr" as specified in monitoring requirements of permit.
<br />5. Enter "Sample e'+L m'_r,:ent"data for each parame+xr under "~a,rriry"and Quclity~" as specified in permit. "Aver~,;~" is
<br />nomally arithmetic a~~enge (geometric zverage for bacterial parameters) of all samp'o mesure:renrs for eech pe;cmcter
<br />obtained doing "Jv,%niJOring Pariod'; ";trxinuua" and ~'diniemm" are normally cxirc-re bigh and low mcasur:menu
<br />obtained during "ivJc:rilorirrb Pzris_!". (Note to mua;c:YZls with secondary ireatmeit rec uiremcn[: Enlrr 3C-day averzg~
<br />of sample mezsure~~ents under f'V.'.'ae,;,"and Ciltfl me:<IIr1Um 7-day aVCragC Of S£mple mC2Slll'erC.niS Obta~~ad dl''~n^
<br />J
<br />monitoring perod under "ivJaximun.")
<br />6. Enicr "Pzrnit Re.;mirzrnen!" for each pzra.~etcr under "QuontiN" and "~ierality" as s ~eci ~ icd in pe~7il ii.
<br />7. Under "Ara F.x" enter cumber of sample mess.~r_ment d1*ing :~onitering ; eriec? thrt c.~c~ed ma:cimum (and/or min' num
<br />or 7-day average as sppropriatc) pe,-mit requiremc.a ;ur each paztmztcr. Ifnoae, cater "0".
<br />$. ~r.ter "Fr;:grr~;a^l %f.4rrslys%s" both as "S.;;n, !_ ;rla. srnaraa;; " (actual ficyuercy of sampling znu ena!ysis used d~': ~- ;,•
<br />:notitorngperiod)andas'PznnirRz.luirsnrsrr!"specified in permit.(e.g.Enic; "..~..r',"forcortiluous ~onitorin~, "I/7"
<br />fur one gay per ~:'eelc, "//30" for one day per moour, "1/90" for one day par quarter, etc.)
<br />9. Pn:er "S~nrple Type" both as "S_~,apA• in~asu".ir~i.,"(actual samp4 typo usc3 during monitoring period; and as "Pdnail
<br />RR~uir:mc~r!," (c.g. Lnter "GroF" for i~idivid~ral sample, "1dl1~" for 2~,-hour cemposife, 'SV/A" for continuous
<br />monitoring, etc.)
<br />10. Rrhere violations of permit rcnuirements rrc reported, CY~3di a bref explrnatien to descr'bc cause and wn'eciivc sctiu -s
<br />to be ta'sen, and reference each violation by date.
<br />I L If "no discharge" occurs during monitoring period, cuter "IQo Discharge" across form in place of data entry.
<br />12. Enter "Norne/Tillz of Principal Exenuive ~~cr" with "Sign.rrure of FrinciJ*_~l Ecectrtiva O~rer of Authorizzd
<br />Agent, ""Telephone Number, "and "Date" at bottom of form.
<br />13. Mail signed Report to Cfiice(s) by dale(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Monitoring IZ;porK (DMI~ form may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to repoR truthfully can result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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