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~ Paperwork Reduction Act Notice
<br />~ui,i i~_ ~cp nLnf ~"-~" frr :his co!!ectirn of iefrrra=ri~n is r_ctimated to vary fmm a ranee of t0 hours as Art
<br />average per response Itor some uunor faciliues, to 110 uuurs ~ ~, u.,..~6,, ;,u ,,.,N..::,._ ;vr .,.,u._ -.r,.'jc; ;,.i:l::::;,
<br />with a wcight~ average for majoi and tmnor F rldt.:., of :8 hours pet repo^=_, ~~c;~!d~ng !i^~~ f^; revizwiog
<br />instructioos, starching existing data sources, gathenng and maintaining [he data needzd, and cumpieiing +utd
<br />reviewinti [he collection of information. Send comments regarding [hz burden estimate or any other aspect of
<br />', thin collection of tn(ormalioo, including suggestions for reducing this burdeo, to Chtet, Lotormauuo Policy
<br />i Branch, PM-223, U.S. bnvrrnnmenial protection Agency, 401 ivi $ircet, 5W Wa:,hingtor,, DC 204.,`0; and to the
<br />O(tice of information and Regulatory Affairs, Office of Managzment and Budget, Washington, DC 20503.
<br />General Instructions
<br />1 If form hac been partially complzted by preprinting, disregard instructions directed at entry of that information
<br />already preprinted.
<br />Z. Enter 'permittee :L'nme,'Alai(ing Address (and facility ttamellocation, S dttfcrcnl)," "permm Number," attd
<br />"Di,cchnrge Number" where mdreated. (A separate fornt is required for each discharge)
<br />3. Enter d::;es beginning ;md end!ng "Alnnitonny Period" covered by form where indicated.
<br />4. Enlcr cacn "Pnramen•r" as spcc!Gcd in nu,;uiu!i!ig raluacn:cnts of pcnnil.
<br />5. Enter "l'nr„Ph- llrmvrenu•nr" data lbr e.rch par,rmeit.r unri~; ~ f)nanurv" anu "i%:~,dlh" in wits ;pecificd ;~ ~c,^; :;.
<br />"a verngr" is normally aritl~~mctic average (gcuwct~-!c z~c.aoc for bacterial parameters) of all sample meas~!remenls
<br />for each parameter ohmmcd d~!nng'.lhnmm~nv Pc•-'~,d' afururmnf' and "11r+i'num" arc normally ex'.remc high
<br />and lout measurements obtained durng ",lluniroring Pcvn~d" (Note to mt:niap::!s ccilh secondar,~~ t~ea[ment
<br />requirr,rcnt ~ntcr'+'!-dc•; a.~•n;^ of c~r~pir mesa!rcmrnls under "Averogr." god. enter maximum 7-c~.:v average
<br />of sample measurements obtained dunng monrtonng pcnod under "Alru~rrruuu. ~i
<br />fi. Enter "f'ernw Keyurrenrcnt" for each paramcic: duller "Quwr.'i:y" and "Qunii,~" s specrf~ed !n permit.
<br />7. Under ".\'r, F'r" enirr number of sample mcasurnn:nis during monitoring period that exceed :.u*ximum (and/or
<br />mininmw u. '-•.',.;} :, -- ~ ,.. -^ •;^,^ ^^rr^ir ^'^,,~~•e~„r,,, far each nammeter. If none, cuter "G"
<br />..yC ::~.r..,~.. ,.. ~),
<br />8. E:rcr ~'rrryu sc) uJ~.ir. ui•, •r, .,,,,;. .,. -, .... ... .. .,'~~ ,l Lprnu`nC{' of sampling any u~.z..~s i,Sid
<br />during monitoring period) and us "pcnnil Kryuire,nenl" specified ir. pcrn~!t. (e g., Enter "('ont,- for continuous
<br />mOnitOr!:"o'. '• r ."' far nor day p; r wC~k, "1 :i 0" far O4r da}' par lnm;l't "1 '~~" fpr one day per en_°rlCr, etC.)
<br />_ ,... , , .,, .--,, "t ,..,..i~ „~ ,~.,.n dnrine mou!twmg penodl u:~ ,_..
<br />9. Enter .iunrprc rypc- uur,,.u ,~.u,,.p,. ....:i.d;;:;:... .-•.a.,. s.:.,.r._ h, _.
<br />"Pernul kequrremc•nr," (c.g, Enter "Grab" for indn•idual sample, iP?JNC' iur 24-hour composite, "\'.t" !o-
<br />COn1mUUJS a:wuiOring, Ctp.)
<br />10. Where violations of pernul requirements arc reported, attach a brief explanation to describe cause and corrective
<br />actions 4'dtcn, and reference each violation by dale.
<br />11. [f"no discharge" occurs during monitoring period, enter "Nn DrschorRe" across form in place of data entry.
<br />12. Enter ".Name./Til/e ojPrincrpal Execulrve Officer" with "S'ignalure ojPrincipal E:xeculive Officer oJAulhorized
<br />Agent," "Telephone Number," and "Dole" at bottom of Conn.
<br />13. Mail signed Report to Office(s) by date(s) specified in pcrnti[. Retain copy for your records.
<br />l4. More detailed instructions for use of this Discharge Aforritoring Report (DMR) form may be obtained Gom Ollice(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 report truthfully can
<br />result in civil penalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed x25,000 per day
<br />of violation, or by imprisonment for not more than one year, or by both.
<br />EPA Fotw 3320-1 (Rev. OS-95)
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