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- - -- ~ -,' • rwork Reductiton Ac•# mice -- - - - --.'I,
<br />I'ubhc rrrurticg hurd.m f:: ohs ,~:i!zetiun of mfurmaln ~n is estimated u~ ~;rry fr~~n~ 1 I:.nge of 10 hours as an
<br />avornbc err rospumz tors •~.:e mr:,,r ;acili:io,, to 110 h~~ur as an average Irrr 'r twn~~-. for some major (unities,
<br />wub a He:ghted ove:..gc :~.~: n:ut.,, and minor facilities of lf. hours per lesfon e, i!. ludmg time for reviewing
<br />:n4na~:~~as. :o. a-ehi:.g ox.. ;: g ~.._ ,. ~u tees, gathznng and maintaining the iota Herded, and completing and
<br />ray icw~~:g 'he zuilzu:;i~~n .:i : ;(urn:etloa. Send comments regarding the burdca estimate or aay other aspect •of
<br />.hi; .,...."ion cf ,n!u:nu. ~.~:,, in"udlrg r.uggrstiuns fur reduci»g thn:; ~lul'd:n, to thief, Information Policy
<br />u:y:ch, P>.9-2~3, U.S. Er.+,.~ :.nirmul PrutuuuH Agenry, 401 M Street, .S`N \~ ~shinF~,ioH, DC 20460; and to the
<br />Cf;icz cF Inforlns:ioo =rd r.,:gula:ary Afteiis, Office of M1lanage:menl aHd Ihrdget, WashingloH, DC 20503.
<br />General InstructiorLs
<br />1. If .form has bezH partia`y completed by preprinting, disregard irustructiotts direcnxl a[ entry of tLa[ iHfortmlioH
<br />already prepriHted.
<br />2. Enter 'Penniltee .5'am~~ 51aiLng Address (and facility name/lopuoq if dit7erent)," 'Perini( .Number," and
<br />"Discharge Number" wl:_re indiptcd. (A separate form is required for retch discharge.)
<br />3. Enter dates beginning and ending 'Afonirorirlg Period" covered by form where indipted.
<br />4. Enter each "Parameter" ss speciCed in monitoring requirements of permit.
<br />5. Enter ".Smmple Alenau-::,ent" d:lta for each parameter under "Quantity"' and "Quality" in units spedlied in permit.
<br />"Average" is normal!} ~~~hmeiic average (geometric ;,vemge for bacteria parameters) of all sample measurements
<br />for each parameier ot.a;-.;rl dwing ",tonitoring Period'; "Maximum" and 'ltfinimum" are normally extreme high
<br />and low arteasuremen;s ,;htatned during ".tfoniloring Period." (Note to municupas with secondary lrptntent
<br />requirement: Enter ]:)- u:} a~.c-:ge of sarrple measurements under ".4.nrrage," and enter maximum 7~ay average
<br />of sample measluemeru obtained during monitoring period tinder "Mrulmwn.
<br />E. Enter "Penmr.5eyuire n.. r, P' for c~ch parameter under "Quantity" and "Quality" as specified in permit.
<br />7. Under "No Ex" enter ::;.tuber ~` sample measutments during monitoring period that exceed maximum (and/or
<br />minimum or 7-0ay ova: ge as apn:opriate) permit requirement for each parameter. If none, enter "0".
<br />8. Enter "Freyuer:cy of ~t! .~ jail" bath as ".Sample ,tlca~unnrm" (actual frequency of sampling and analysis used
<br />during monitoring period) and :IS "Permit Requirement" specified in permit. (e.g., Enter "Coot," for continuous
<br />monitoring. "1'7" for JL.: da}' p,_r ~.veek, "1.30" for one day per month, "I,'90" for one day per quarter; etcJ
<br />9. Enter "Sample Tvpe" !x~:h as ".~cmple ,Ifeasuremenl" (actmd sample type used during monitoring period) and as
<br />"Pennir Reyubemera." .,e.g., Enter "Grab" for individual sample, "24HC' for 24-hour composite, "N/A" for
<br />continuous momtarir. „: c.)
<br />l0. Where violations of .errdt requ:ements are reported, attach a brief explanation to describe pose and corrective
<br />actions taken, and re('arr :ce each violation by date.
<br />11. if "nu discharge" occurs during monitoring period, enter "h'o Discharge" across form in place of data entry.
<br />12. Enter ".5'an,e~':f7e cf r':.rcipal,i;ecwire Officer" with ".S}gnature oj!°nnerpa/ Erecu6ve Officer ojAurhor:ied
<br />Agent," 'Telepl:are *.nl.ber," and "Dare" at bottom of form.
<br />I3. Mail signed Repcn to G:Lce(s) by date(s) specified in permit Retain ropy for your nxords.
<br />I4. Afore detaled i:lstrtrc(iors for use of this Discharge,tloniroring Report rDMR) form may be obtained from Ol~ce(s)
<br />specified in permit.
<br />Legal Notice
<br />This repca.s required by I:.v ;,33 U.Q.C. 1318; 40 C.F.R. I25.2~). Failure to report or failure to report truthfully can
<br />rz=u;t m : rcil yeHa[tizs out ~ •„ .: t~.zd yl O,OW per day of violation; or m crimunrn penalties Hot to exceed f25,0IX1 per day
<br />of violation, or by imfrittm:r.,:. for nut more than one year, or by both.
<br />EPA Form 3320-1 (Rev. U--:%1
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