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<br />Nuhlic reporting burden for this a,lleclion -~I' inlilrnation n zslintatrJ to var}~ from a ranee of 10 horn as an <br />ulzctge ore response Inr some minor I'ac hies, to I10 Fours as an overage pzr re-aonse for xrne ma,ar <br />Rlcilities, +cith a ++eighted uvcroge for ma;n- and minor lacilit its of 18 hocrs per rcsp mse, incluuin~ time br <br />rcviescia_~ instructions, searching tahtm~ data sou«es, guth,cring and Inamtainirg the data r,.Jrd. and <br />cnmalelu~, and rzciewing the collection of ~:~'ormat~un. Sznd :omment, reeardmg the h irden estimate or m} 01 tzr <br />aspect of [his collection nl informaunn. ircludine suggestions for reducing this burden, to Cltiet, 'n'ormat.nn <br />policy Brunch. P141-1_'3, U.S. Environmental Protection Aeznc}. 401 ~1 Start. SIB'. PasFington. DC ]`1460; end <br />w the Oll~ce of Inl'ormntiun and Regulatory Aflair.. Office of Ih{nagemznt and Budget. Washington. CC ?Oi0?. <br />L. - - - - - <br /> <br />I. II lirlm 1185 bee^ piIrllJllV l'OmplC Lid I); prC pflmill^p, di\fegard InStfnCllnnS directed ~ t entry of !' at .nlnrmaliun <br />a'read} preprinted. <br />'. Fn[er "Permitrec Nume.- Ilailutg WJtr.~ (and fscdity n:une;'Inc~aua•.. if Jil%rcnt1.- "Pernur Number." al d <br />"Discharge Number" xhcre indicated. IA xpa rate litrm is reynircd for each Ji+chnrge.) <br />.. Fntdr dates bzginnine and anding "blortiro~'mg Periud~' catered M form 11 lsrr Indicated. <br />A. Enter each `Poirantrrrr" u5 5pecil icd in nnlniturntg require dents of permit. <br />F.ntrr "Sdmplr Mcosur, meat` data frr zudl p,i r.~~~:etcr under "f)udntitt" and '(Ju:Uii}' in units sprr•,I ied in permit <br />"Avrmee' I, nonnsll} nntluneoc dlrru$r Ipenmerric averlpe fcr hacten.il parametenl ~d' all sample mcusuremei s <br />Inr each pars llletCr nMal nrd duliny 'dlnmtnring Period-': '.Ndrimmn` anJ ";1l uurnmm ore normolll es[renlr hi~F <br />and lute nteasu cements obtained during `.ilunit~a~mg Prrrad'" 11urr In umnieipal5 ~.: ith seconds n: tee: Into ct <br />requirement: Enter 3U-Ja} overage of ,ample mcasmcmenis under "Are rtge.' and tmrr masimm~ '-da) c l'emge <br />of sample meaty cements obtained during muniuxing penud under "~~1d rimum:') <br />h. k:nrcr "'Prrnrit Requirement- for call pdrsrcter under "Qu:wtit)~" and "(Jma/n}" as spccifleJ in permit <br />'. Under "Nn Ea" cn[el number of ,,rmpl~• mrasw ements durng mnnnorin~ period that rscced rt.i~Lnum bl-td; rr <br />nt.nimum ur 7-day average xs apprnpnatel termit reyuiremrnt for each parameter. It not e, enter "(I". <br />ti. Enter "I-reyueney n( Analysii' noel. as 'S.rrnple A9easirement' (actual frequency of ,a mpling and ..tat}sls used <br />durinc monitoring perindl and as "Prrnnr Reywrement-' spenlicu m permit. (e.g Enter "Cunt." lilt cominuou, <br />nmm~orin@. "!,'7" fur one day per ace6. "I .U" inr one da} per month. "l,'9U- Inr one Jay per yuan;r etc.) <br />q. Enter "S:nnpl~ Type" both m "ti;unp/e arr.nuremenl' (acwal sample qpe useJ during momtorine pe'iodl unJ us <br />`Permit Rcyuiremtnt.- (e ~. Fn[zr 'Cl rob" Inr individual xunp'. e. "?•!HC-" for 34-hour vnmposi[e. "r\'.~A" Inr ccr.- <br />ununus monitoring. etc.l <br />10. Where siolatians a( permit rce,lirrmen'n ,.re ap,lrted, aUach ,. brteC zspCanatiat u. d. ;tribe taus.: and curertise <br />actions ta6en. and referen.e each siolauun t. date. <br />I I. If "no Jischa rge" occurs durng mon~iorim• pen~d. enter ".\'o Discharge" ac rasa (non in place of da;a ri try. <br />L'. Later "Namr,'Titlr of Yrnclpol L+rcuril: Ullkrr" with `Signanu'e o% Prinerp,ll L~!rcuit•e Officer nr AurharizrJ <br />Agent," -Trlephnrrc :`~umbrr,~~ an. "Dare` ... bnlton• of form. <br />I ~. Mail Signed Report to OlYlcn,l h} d.ue(si .peril ied in permit. Retain cop} lift }our Iccords. <br />IJ Vnir detailed InSt rucnnm (or out nl thi, Uuchnrge ,Ikrndnnng Rrper't tUMR) (n.m may be ohtairid fnln O~- <br />fire(,1 ,pecified m permit. ~i <br />I his report N required be lull (.+3 1..5.C 131M; 40 CI.R. I?5."y. Failure to report or ".iilure to rzporl IrutMuliy ran <br />rt.ult in civil penalties nut ut rscezd :610.000 per du} of lielai~an: nr in crlmmal penaltic. nut to esr:r~l ti?50'x0 per <br />.,.I> ul' uolatiun. or b} imprisonment the nut nua~ than one }ear. ,.~ by both. <br />f F'A Form .3.110-I IRcs. 9-881 <br />