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I'~.~+erwork I~e~~~4~on Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of ] 0 hours as an
<br />average per response for some minor facilities, to 110 hours 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 sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information, including suggestion for reducing thi:> burden, 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 Instr:~ctions
<br />1. If form has been partially completed by preprinting, disregazd instruction duetted at entry of that information already
<br />preprinted.
<br />2. Enter "Pzrntittee Name/Mai/ing Address (and facility name location, if different)," " P2rmir Number," and "Discharge
<br />NumEet' where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dates beginning and editing 'SYlonitoring PrricJ"covered by forth where indicated.
<br />4. Enter each "ParanreN_r" as specified in monitoring requirements of permit.
<br />5. L-nter 'Barrpl~ NI asz'r~,;rent"data for each parameter under "Quantity" and Qua/ity"as specified in permit. 'Aneragz" is
<br />normally arithmetic average (geemeL-ic average for bacterial parameters) of all sample measurements for each parameter
<br />obtainer dunu~ "L-i%rrilorinn F,.•ri~d"; "%~11xir:rur.r" and dlirri:;una" ar.: normally c:.7crne high sad ]o~.v mca5ure~rcits
<br />obtained de'ing ";vTnrih.~7r;.; .r'~rio.t" (\eie to muticipais sviih secondary treztmco: requirement: timer 30-day aver2gu
<br />of sample ;roast rcmenls under ",iv~rag~,"and enter ma:imu.-t 7-dzy outrage of sa~r~ple musurcmcnts obtziocd during
<br />monitor~og period under "iv;,ui;nma.")
<br />5. £r. c.r "?e,ri! Rr~t•irentart" for each paramc:er aadcr "Qulrrri~ "a;.d "~malih,"ss sp _•cified in 7crmi:.
<br />7. UnL~:r "r~'o ii•' cn:c. numccr of sample mc: pure.-c ri ~ ~ ing monhu:ing cciicd that c ._ccd maainum (: ndJor minimum
<br />er ~-r:ay ::~~'age:=. a?nropriate) pe~rri: nuuiremcnl for cacti partmctu~. :f Done, Otte; 'G".
<br />^• °r c "; r..•e',. ; ~f;',r,/~sis"L-cC.i .~ "~.r,,.pL .."~~s„r:,a-;,/"'a~t~a: E~qc:~~y of s~r,~oiing rn.i aca~ysis rsal dtnin~
<br />~~•.r.:Iw,nr, .~aiud) znd es "I _~:;i.r /Z~!:ur-•rr,-nr"spccifsd ;n ;,uT~~i:. (c.o 'n!cr "~•.n,,"for wnlicuo~~s r o.ii!u~irg, "1/7"
<br />fur ~rcCi2; i;er s:•ee':, "1L30" fo.- out da% },er mou.u, "~r9G"for one day per yuartu, c~c.)
<br />~. '.n..; "S?n•I"1J T)~:" LUin as 'S.~;af 1: ~ v_sco, s,;tr,.:" (sctual ramnlc typ: usc3 during ~^:onito~ine ncriod) and as "r.,;nir
<br />fi`:~rrir_,rtc,~{" (c.b. . ~:cr ".;r~i~" ion indivii~u_: sample, "Zdil," fen 2~._hua~ wmposit;;, ''.\%/" Tor contincaus
<br />monitoring, etc.)
<br />:0. '~'/:ienr ~.~ol.::i.rns ofpe~mit requirements zr,: r.porlu!,'.•ri:cil e bricftrpsuns:tea In =•=scribe ew.•e rnd cerrec:ive ac'iuws
<br />to be ls4;cn, and reference each violation by date.
<br />;'. If"n., discharge" occurs daring :nonitornrg period, rnter "1':o D~scharge" across for;n nt place of cat2. entry.
<br />12. lin:cr '7da;;rJTi/le c.( rru,~i(_rr F.r_:zdir: G~~_r" sviCu "Sii,~uurrr ~j Fr~ncir~! Fr__xtnr Gjri_sr of ~IuIF,~„~izsd
<br />:,~e;:t, ""T:1_F'r•,ne n'uarl•zr, "and "Do1~"at bottom of form.
<br />13.:J,a~l signed Report to Office(s) by date(s) specified in pcrrnit. Retain copy for your records.
<br />'.tors delailcd instructions for use of this Disehlrb,: rl4unitonng RF~+? (G,LIFJ furn may be obtained fmm OfGcc(s)
<br />s~ccified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.P.R. 125.27). Failure to report or failure to report truthfully can result in
<br />civil penalties no[ to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for vot more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03199)
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