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r- - <br />' !~~:~C''~'~ir.",'_""'. .e~v'.~'~~°tIE~'." Fal'yi I~~.B~t'"°;^r <br />Public reporting burden for this collection of information is estimated to vary from a ru)gz of 10 horn as an <br />~ average per response for some minor laci!ilies, hr I10 hours as an average per resfonse for san•z nair• <br />facilities, with a weighted average for major and minor facihlies of 18 hours per res;onse, including : me 4 <br />reviewing instructions. searching existine data snr recs. gathering and maintaining t'te data ace.'cd, and <br />completntg and reviewing the collection of inlbrmattor. Send comments reearding the burden estimate u• ray uth. <br />aspect of this collection of informaunn, inrudmg suggestions for reducing this buruen, to Chief. InGrmaunr. <br />Policy Branch. PM-213. V.S. Environmental Protecpen Agent}. 401 M Streit. SW, Nash~ngton, DC '_U4S0: ~:nd <br />to the Office of Information and Regulator} Affairs, Ofltce of 11anagement and Budeit, Washington. I): '0~~' <br /> <br />I If form has been partially completed by preprin:~ng. disregard instructions directed at entry of tl.u: inionnitn.n <br />alrzady preprinted. <br />3. Enter "Permittee Nume.~h/ailing AJrlress (and facility namelloanion. d ddferenU." "Ptrrnir 'v:~nbir.~ and <br />"Discharge Number" where indicated. (A +e-ra rate lirrm is reyw«d for each di,charge.) <br />_. Enter dates beginning and ending "rllnniroring Yenud" covued by form where indicated <br />4. Enter each "Paramerrr` as specified in monttoring requirements of permit. <br />~. Enter ".Sample Measurement" data for each pa r.uneter render "Qunnrir)" and "Qa'rlirt" in units sncc ~ .d in p:rm t. <br />"Areragt" is normally arithmetic :n~erage Q:ennteu~ic average (o: bacteriol pa runeter,l rl alt sample ~m.nu rc ten.. <br />lur each parameter nbiaurod dm ine -;18crrurnring PcrioJ-: ':Llu rinmm' and "'.Llimnm m" are nonnr.lly ...•ir-r. hi~:h <br />ant low measurenttn[s obtained during '"Llnninaing Perrod." 1\otc to municipals v. ith seconds-, Irea.moJ <br />requirement: Enter 30-da} average of sample measurements under "Avrrrge." and enter nnnimur =-d it a. =rata <br />of sample measurements obtained Junng moniroring period under "kla.eimunr.`) <br />6. Enter "Penni[ Requirement" for each parameter under "Qu:mri~r'' and "Quality" as speafitd in permit. <br />7. Under "No Ea" enter numbzr of unnple measurements durng monitoring penod ;hat exceed n~.:v rrnm uutd •~~- <br />minimum or 7-day svernee ac apprnpriatet permit requirement for each parameter. If nonz. enter '0~~. <br />S. Enter "f~reyuency of Analysis" both a+ ".S':unple Messu rrment' (actual Frequency of sampline snC .n.a lysis useJ <br />During monitoring penod) and as "Permit Requirement- ;pecil'ied in ptrrnit. (e.@. Enter "Cone,- in- conti::uon, <br />monitoring. "I; 7` for one day per weeA.'1, :70" for one day per month. "l,'9(i" for o~.r d:q per quarto. etc.) <br />y Enter "Samplz Tvpe" butte us "S:rmplr M1lcasurement" (uuml sample q~pe rued dining monitoring period) and a; <br />'Prrntir Requirrnrent." (e.g.. Enter `Grab" fur individual sample. '"ZdHC' for _'4-hour composite, "V'A" for cm- <br />linuous monitoring, rtc.l <br />10. Where violations of permit requirements art reported, an.rch a brief espla natirnr r Cescribe cause and correcti.a <br />actions taken. and relerenre each viulanar b} date. <br />I I. If "no discharge' oreun during monitoring period. enter "No Discharge" across (non .n place ul' data entry. <br />12. Enter "Namrj 7~irlr of Princips! Frrcurire Officer" with `Sienamrc o!' l'rnn•ip:d Errcr.nve Officer n,` AurhorireJ <br />Agent,' `Telephone .Number,` and `Dare" at bottom ul' (orm. <br />I:. Mail signet Report to Oli ice(s) by dste(sl ,pecil'ied m permit. Retain cup} for your r.Card,. <br />IT. Mort detailzd instructions for use of (ten Disch.uge ,4fonirorine Report (U\7R) lorm may be ohtained (mm OF- <br />(ict(s) specifieJ in permit. <br />E.~gal ]~s~tice <br />This report is required by la.r (37 l,'.S.C. I117`: 40 CF.R. R5.'_7). "situ re tr. rc l~~ort or I;ulure tv rcpor. ~ur hl rd) czn <br />result in purl penalties not w excctJ SIU.000 per day nl violation: or in cri nti nal perat~e, not to exceed S25DI10 per <br />day of violation, or by imprisonment tin urn none than one year. ur by both. <br />FPA Form 3320-I (Rev. q-881 <br />