|
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 aad 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, disregard instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Permittee NameliLfoiling Address (and facility name/locatioo, if different)," " Pzrmit Number," and "Gischa~ge
<br />Numl-er" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing "6fonitor•irrg Period" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "S1mplz Afaasw-ement"data for each parameter under "Quantiq~"and Quolitj~" as specified in permit. "Avenge"is
<br />normally a~[hmetic average (geometric average for bacterial paramoters) of all sample measw-cmcnls for each paranctcr
<br />v'c*aincd du•-in~ ",b/;r~ia~rirrg Period'; io9rir:rrm" end ,Lfirriuuun" arc ro:-mally c;:ir-ne high and !cw meas~.ramenfs
<br />obtained durnU "d;•,nilc, ing Pzriod". (T~'o[e to mu.~.ic:aals v~ith secondary treatment roquirement: °ntcr 30-day average
<br />or sa,.tplc measu-emcnts under "Average," and enter mzz~mum 7-day average of sarnp'_ measurcmcnG obtained doing
<br />monitoring period under "ivfaximum.")
<br />5. rn+cr "Pr,-,;tit R.tquir~ment"for each par~nretcr und.:r "~:~-.;t%ty"and "emu ~liN" as specified is ; ermi:.
<br />7. Un:ler "N-: E.r" cn:e; ^umbcr of sample mc~surement during ~r.on~to~in„ ~ ~.=riot that ..:c;ed maximum (tnd/or 3iai,nem
<br />c. 7-dcy areraoe as appropriate) permit requirement fur each parameter. Ii none, ent_r "0".
<br />8. nier "Fra_1rrenay of.lnaFsry" both as "Burr !z ivLast-rt,a~.t1" (acCi~l f:equrrnc;~ a' ~nnpling rod ana=lysis used dvrirg
<br />monitoring period) end as "Pc„ni! Re.luira+iSrrr" speci~icd in permit. (e.g. L-nte, " .z,r!,";or continucus ^aonitoting, "//7"
<br />f~.r one day per wee!c, "1/30"for one day per monGt, "Ii90" wr one dey per quarter, etc.)
<br />S. Enter "SamFld TyFa"both as "SanrFle ivl~JSr~3ar~,d" (actual sample type used during ruanito-icg ne~icl) and as "F.„ail
<br />Ryeir~nre.r!," (e.g. enter "G,uY' for individuai sample, "2BH':" for 24-1;,, r composite, 'i1%A" for continuous
<br />monitoring, etc.)
<br />I0. !~,R•ere viola[ious of permit requiremeots arc repor'~ed, attach a beef cxnla.ra~ic tr. dz,cribe caese and corrective a_:ions
<br />to be taken, and reference each violation by date.
<br />11. If "no discharge" occurs during monitoring period, enter "t~`o Dscharge" across torn in place of data entry.
<br />12. Cnter lVame/Titk of Principal Executive Gjjicer" with Si~vtaur%;; of Frin_i~ ~1 Lt..•rrtivz Gfficer of Artho~ %>ad
<br />Agana, ""Telephone Number, "and 'Date"at bottom of form.
<br />I3. i\4ail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Monitoring Rapo:7 (C1vfR) form may be obtained from Oftce(s)
<br />specified in permit.
<br />I.e~al Notflce
<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 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. 03199)
<br />
|