|
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 1 S 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 Stteet, 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 "Pennittee Nume/Mailing Address (and facility name location, if different)," "Permit Number," and "Giscl~arge
<br />Nun76er" where indicated. (A separate form is required for each dischazge.)
<br />3. L•'nter dates beginning and editing "Monitoring Pariod"covered by form where indicated,
<br />4. Ln[er each "Parameter" as specifted in monitoring requirements of permit.
<br />5. linter "Samna N.'zo.r7n-au7e;rt" data for each parameter under "Qumrtity"and ~ualit}~" as specified in permit. "Ave:aaa" is
<br />no-ma11y arithmetic average (geometric average for bacterial pzsmacrs) of sll samplu measurements for each parameter
<br />obtained during ",bi:air;ri+7g FerioJ'; '7/..~a~in7er7" znd !.>ini,runu" are noRnally c;ar:mc high and low measurements
<br />obtained during "+:~-.rul~,.-i;tg P~rixf". ('Vote *o mu-icinaLs vnt(-~ seeendary trcalncnt rc~uirem~nt: _?nter 30-day ave-agc
<br />of samnlc mcaserema-'s under ": v_r~ ~ end en'cr -~~zir, um 7-day average of sin;'„ me~su crc~n's ~h;ui~~d during
<br />monitoring period under "ivlazimt7m.")
<br />J. ;'stir '.°zr%;7It n?~A'ir'LU16a/" f J; each ps:an+c:zi IIIICCr "iiG7:7:ir'O.:G.ai "L#1!i ~'" a5 :'peciued in permit.
<br />7. Uncle; "Plo Ez" cn`.r cembor of sam?le mersure~cnt durng men%taring prriad tiiat :::eccd maeima-n !rnd'er c~inimu-*~
<br />cr 7-day avcrtgc as z?prepriatc) pemit rcyuircmcnt for each parameter. If none, enter "t7".
<br />8. Lntcr "Fra,lve+~ ~ ~,f?,r.71~sP."both as "ter ,-!.: ,fvsr;~.n~nr" (och:af frequcrcy c°sanpl~n~ end znrlysis used :'firing
<br />moniutrir,,; prr cd) . nd as "P ~.;::fir R~~; uir~, ~ =,r+" s,,ccifed in pc, ~r;it. (c.g. Lntcr ',.•..7t, "for cor,Enucas .-nor,itorin~, '7/7"
<br />for one day p.r week, "1/30" for one day par month, "t/90" for one day rr.r quarter, rte.)
<br />9. .rimer "Sa7.rFl_' T;yti?" boi't as "S~;r:%t_ n' .'sr'.-~;:r"; ~" (r'.n!al svn?Ic type used deri.ig tronitoru g period) a^d as "I'e::,:%t
<br />1F~guir,a:.a," (e.g. ;inter "G,~l-" fur i-dividual s^mplc, "2411" for 24-hoar cmnposite, "r`w%A" for continuous
<br />monitoring, etc.)
<br />10. ~\>lu:rc violations of pe nail regrirzmcats a; ~ iuoortcd, attach a brief ezpl2n :tiny to dcsc;ibu cause and corzctivc actions
<br />to be taken, and reference each violation by date.
<br />11. If "no discharge" occurs durng mcnitorng period, cn?cr "I~'o Disc;l;arge" across furrn in plzce of data entry.
<br />12. Later 'T7ame/Till_' of Friucir:71 lr..:re!iva r~.:_'r" with "SiKrrateua of Ain.:iFv( 4'rscutive O~~er cf Authoriti~,y
<br />Agent, ""Tzlepl:rn7z Numl-er,"and "L'ate" at bottom of form.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records.
<br />t4. More detailed instructions for use of this Discl~argr Monitoring Repo+4 (GMRJ form may be obtained from OtTicc(s)
<br />specified in pertnit.
<br />~.egal 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 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 imprisotunent for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
<br />
|