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Paperwork Reduction Act Notice
<br />Public reporting bwden for this collection of information is estimated to vary from a range of 10 hows as an
<br />average per response for some minor facilities, to 110 hows 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 sowces, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information, including suggestion for reducing this bwden, 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 />If form has been partially completed by preprinting, disregard instruction duected at entry of that information aUeady
<br />preprinted.
<br />2. Enter "Permittee Name/Mailing Address (and facility name/location, if different)," "Permit Number," and "Discharge
<br />Number" where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dates beginning and editing "Monitoring Period" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "Sample Maasuremenl"data for each parameter under "~'aantity"and ~iuafih~"as specified in permit. "Avzrase" is
<br />normally arithmetic average (geometric average fo; bacterial parameters) of all sample measurements for each parameter
<br />obtained during "rLlaciroring Per%oa'; ",LLri;mm~" and Miniurwn" are normally c;arcmc high and low measwcmcnts
<br />obtained during "i,/,nitoriug P~rird". (Netc to municipals with secondary trcatmen: ~zquiremcnt: L-nter 30-day nve-agc
<br />of samplc measurements under "Average,"and enter -~zximum 7-day average of sample mcaswemcnts ottainzd du~icg
<br />monitoring period under "IVlaximun..")
<br />5. En'cr "Perr,7it 12eyuirznau" far each pamtnebr under "~u.vrtity"and "Qerair~"as specified in perm;[.
<br />7. Under "!~!c Ex" enter number of sample measuremrnt during mnn~tc~ng period 1}at e,:e:ed maximum (and/or min~mnm.
<br />or 7-day avercge as appropriate) pcmit rcquimeat for each parameter. 1 f norq e.rtcr "0".
<br />8. Enter "Frzynan;y ,jArulysis" both as "S~„~~ 1e .A_ ~ urz,run!" (actuzl ~ equercy ur sampling and are lysis used dung
<br />mo, iioring period) and as "P:.,;;ri! R ~l:rirem ant" s,:ccificd in perm'a. (c.g. ~ntrr "^%;n, ";ar contnuous n~onitorirg, "1/7"
<br />fo-one Say per v;ce:4 "1/30" for one day per month, "1/90" For one day per quarts ~, uc.)
<br />9. Enter "SsmpL Type" both as "S1~nFle r..'.~.~u~.z~ae,rr" (actual samplc type a;cd during monitoring period) and as "Prr;;tii
<br />1L:yui;er,:e.ti," (e.g. !;rater "Graf" for individual szrople, "2411" for 24-bcur coroposite, "N/A" for continuous
<br />monitoring, etc.)
<br />10. ~h(here violations of permit requirements a~e reported, attach a br,ef c;cpl.anation to describe cake and corrctivc actions
<br />to be taken, and reference each violation by date.
<br />11, if "no discharge" occws during monitoring period, enter "1\'o Discharge" across form in place o`. data entry.
<br />12. Enter "Name/Title of PrinciFal F..rzartive G~_-er" with "SiAnuha•e rj Prin, ir~l Exzcetive Officer of Auth~.rized
<br />Agznt, ""Telephone Number,"and 'Date" at bottom of form.
<br />13. Mail signed Report [o Office(s) by date(s) specified in permit. Retain copy for yow records.
<br />14. More detailed instructions for use of this Gis./rarga Monitoring Repa+ (DdIRJ form may be obtained from O[ficc(s)
<br />specified in permit.
<br />Legal Notice
<br />Ttris report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failwe to report truthfully can result in
<br />civil penalties not to exceed $] 0,000 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 yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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