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- - ---- i ~~ rti't:i ., a:~~ ;~tion Ac' ?~±tice- ------ --
<br />I~b!ic rq;oairt bura~.n f. . ,,:: ~f ,nfonnaiii,n is estinrateS a r; `rom..r range of 10 hours as an
<br />' avcrtgr per r~<;"~:, ~,.: P:r > . a .c. ,. ., . ~ ~:. to ! ]0 h~::rrs as an averet e i e ~:~ puo~ ~ for some major facilities,
<br />with a u~e:gh.c•.' ..vr.__z : _ ......:..r P~cililies of lE hours pzr i~:;por:e, in:,.udmg time for reviewing
<br />,rst::..;:.:os. ::-.tea ;.:r oa - ~~ .. gathzrr . eras rrcir ainin; he J: a n?~dzd, and completing and
<br />reviewing :he ..o:ic.;:;.rr, +.1 .ntor:,_..,,,:. Dens comma:. rzgarSrng Ih~ LurScr. estin:ue or any other aspect of
<br />this collection „f iufort»_; r. ~. ,.. _ .:;_,gr,th>ns for rcJucirg this. •~u:d.r., to Chief, Information Policy
<br />BrancF., P'vf-2?3, f_'.~ Er.- ~ :.a~.;al' N:ot.r_t{on Agrnc}', 401 M Street, b\V Nashington, DC 20460; and to the
<br />' Office cf !nfornvuior, .md ~ ~guis:o.-/ A.`toin, Offi.e of Management and budget, Wachiagton, DC 20503.
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<br />General Instructions ~
<br />1. If form has been partia~'y completed by preprinting, disregard instrur:[ioms directed at entry of that infonnatioo
<br />already preprinted.
<br />2. Enter "Permittee Name%Lfailmg Address (and facility namelloption, if diffen;nl)," "Permit Number," and
<br />"Discharge A'umber" v; here indipted. (A separate (orm is required for each dischareeJ
<br />3. Enter dates beginning aid end:rg 'alomrorDrg Period" covered by (Dora where indipted.
<br />4. Enter etch "Pararncte, ";.; sped;red in monitoring requirements of permrrt.
<br />5. Enter "Smnpie ,1leasu, r cent" d'na for each parameter under "Quantity" and "Quality" in units specified in permit.
<br />"Arernge" is eornvally arrttunclic avcruge (geometric average for bacterial parameters) of all sample meastuements
<br />for each parameter obt.:.eed d:~ring "Afoniroring Period'; "Afarimum" and 'AJinimum" are normally extreme high
<br />and !ovv measuremenu .;btain.d during ".4funiloring Period." (Note to municipals with secondary treatment
<br />requirement Enter 30-. :, average of sample mcasurcments carder "Average," and enter maximum 7-0ay average
<br />of sample measureme:,is obtained during monitoring period under "Afar;rnunr.')
<br />6. Enter "Penmr Requircurr:.r" for "ch parameter under "Quantity" and "Quality" as specified im permit.
<br />',. iJnder "Vo cr" enter number of sanrplz mcasutments during monitoing period that exceed maximum (and/or
<br />minimum or 7-day aver: ;z as anE ropriate) pcmrit requirement far each ptameter, if none, enter "0".
<br />e. ~ntcr "Ereriuerev ~+j,; .chus" t~th as ':Sample .Aleasunnent" (actual .frequency of sampling and analysis used
<br />dunng monitoring pcrioc)~ and s "Permit RequiremenP' spccJed in permit. (e.g , Enter "Coral," for continuous
<br />monitoring, "!'7" r'or ~r.. Jay ftir ,vicek, "1130" for one day per month, "1 r90" for one day per quarter, etc.)
<br />9. Eraer ".Sample Tvpe" bi~'h ys "^:.n+p!e Afeasurement" (actual sample h7ie used during monitoring period) rind as
<br />"Pernur .4egu;remenr." .,e.g., Lnter "Groh" for individual sample, "2JHC' for 24-hour wmposite, "N/A" for
<br />continuous monitoring„ . c.)
<br />10. :'Vhere violaUCns of ;ietr.rit rr~uirements are reported, attach a brief explanation to describe pose and corrective
<br />actions t:Jcen, and reference each v~olalion by date.
<br />11. ~ "no discharge" xr, rs :;:ring monitoring period, enter "No Discharge' across form in place of data;enlry.
<br />12. Enter "h'ame.r/:rle of P:.ncipal Executive Officer" with "tiitmcture ojJ'rincipaJ Fa~ecu(ive O~cer'ojAuthorized
<br />.4gen t," 'Telephone Aim;ter," and "Date" at bottom of form
<br />13. tvful signed Report tc CI'ice(s) by date(s) specified in pemmit. Retain copy for your records.
<br />!4. A1ere detailed :nstn:c~.~;:,s for osc of this Discharge Aonitoring Report (DtifRJ font may be obtained'from Office(s)
<br />specified in perntit.
<br />Legal Notice
<br />"this report is required by !._w r33 U.S.C. 1319; 40 C.F.R. 125.27). Failure i.e~ report or lailure to report truthfully can
<br />: exult i~ civ;l penaltis not . • ::teed .`~ I O,IXYJ per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />of violation, ur by imfiiscr.~nerr for cut more than one year, or by both.
<br />EPA Form 3320-1 (Rev. O:i-35)
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