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~a~erwork R~~:c~wu~as 1~.ct Notice <br />Public reporting burden for this collection of information is estimated to vary From a range of 10 ho,~ s as an <br />average per response for some minor facilities, to 110 hours as an average per response for some mr;jor <br />facilities, with a weighted average for major and minor facilities of IR 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 this burden, to <br />Chief, Information Policy Branch, PM-223, U.S. Environrrtental 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 Instructions <br />1. If form has been partially completed by preprinting, disregazd instruction drrecled at entry of that information already <br />preprinted. <br />2. Enter "Pzr-mittee Name/Moiling Addrzss (and faz;ility name location, if different)," " P~rnlit Rlunrber," and "Disc'harge <br />Nunlba%' where indicated. (A separate form is required for each discharge.) <br />3. Enter dates beginning and editing "Mcnitrriug Pzrioy"covered by form where indicated. <br />4. Enter cash "Parameter" as specified in monitoring requirements of permit. <br />5. Enter ",Saln~le JLlearu:•emau"data for each pammcter under "` u.rmiry"and ~ualiq+" as specified'o pcm it. "Ar~ai -rs~"is <br />normally arithmetic average (geornchic rvcra~e far bacterial paremeters) of •r,'1 samnlc measurements for each parameter <br />obtaine3 dti ~n~ ".tf,air;rin,; (l~ricl"{ "'derhrem" and 1:f.r: ~.: a.u;" a-e nnrn.lly ? crane high and low mcasur: nerds <br />obt<~ineJ during "P.'••nir,%ino f _•; i•./". (1~'ote to n-:uniun.rls ~, ~:'~ sece Ada ;~ tu7a+m~nt r ~u:rame~a: ]inlet 30-day av~'a~e <br />of samr~le roeaseremens l~.,c'er "Avera~ ~."and enter r:x~ m~- 7-da;• a~'a;age of gar-~-,le mezsurr.~ncr,ts obt: one. ~ur~g <br />non i torin g period under ";Y, axinuua. ") <br />c`. :;n`_~",;,ut.2•;:ri.aaecl"forcachparznct_reader"~/~,ai!,."r•nd"~..u,!/it;+"assp~ci~icdinp°r~T:. <br />7. Unda~ ' A: , h:." enter nurlxr of samo'e r.•ce;u:c-ne,-'. dc.irL r o^".:r[n~ - a2 t' . ..'.c_e.i rna:~.lmum. (crd+cr m~^..-rte'.-, <br />c* 7-day average as rppropriate) ptrmif n.u,uism~ni fur each pa:~r,etcr. !f none, e 1tC "D" <br />$. ):,iii r °J-r1.t" 91.:~~ 'f /„ ohs%e" bntl] as °~'..:Tl. ;/,`rr ~,, .:,i1.+r" (aa;rsl f.c-;ucncy r' cunFil,lg a*.d an.lpsls ^sed c:'~lllg <br />-caitr,rng pcr~ud) r l? as ", ~,,-,.r~rT.;1•i,,•;n:,rr" Sr7cc~Gcd in -coot'. (e.~. ~-_'._, " ,,,r,"for cony ~aacs monitaril g, "1/7" <br />for oac day p°' vec': "r/j0" Fur ane day ter r,.,,~th "1;90" tai arc rl.y per ,luartcr. d~.` <br />9. 'inter "?~n•; 1. T,•7 -' F.nth as "SJal~l.• ..-~.,•s: rz,,.~n~" (;; h:al s:Incl : ty~ ; u~ .d ~t,ri -.g ; ,»,torin~ nerc.') and as "~: r;;; n <br />ke~r,%r, r: r;rt," (e.g. P.nter "Cry+!/' for ind;l-ideal szmpl_, '?41/~ far 2-:-~0 ~- cec polite; "rl'/~;" Cot con[inuc~s <br />manitorng, etcJ <br />10. 1',"ler~ 1 iol.tions ofpcrnit requi,~menls s.: c;;c'~cd, s-tach a anc~'.:<n1.IlaLOi1 ~O (I~.;Crlba cause amt ccre:'ivc aeons <br />to be taken, and reference each violation by date. <br />t I. If "no discharge" occurs during monitorng period enter "Nn Di~cl:ar~e" zcross t, ~n in plrc:, of data cn:D•. <br />12. Enter ",1/ar.1/Titla rf !3•irtu~.! E:,t:util:r Gjf: ~~.•, wi[{, '3'i.i;rJtr:r~ of ,"tin •i; .1 Fre_:nir= O~~er rf /r.llv»'iz.'~t <br />Agent, "'Telephony NumFe;;"and "Gate" at bottom of form. <br />13. Mail s'g~ed Report to Office(s) by date(s) specified in permit. Retain copy for yow records. <br />14. More detailed instructions for use of this Gis:haige MoJliro,ing keFa-t (L';dR) form may be obtained from C~c:.(s) <br />specified in permit. <br />Legal Notice <br />This report is required by law (33 U,S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in <br />civil penalties not 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 not more tLan one year, or both. <br />EPA Form 3320-1 (Rev. 03!99) <br />