Laserfiche WebLink
Reduction Act <br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as m <br />average per response for some minor facilities, to 110 hours as an average per response for some major facilities, <br />v{ith a weighted average for major and minor facilities of 18 hours per response, including time for reviewing <br />instructions, searching existing data sources, gathering and maintaining the data needed, and completing and <br />reviewiog the collection of information. Send comments regarding the burden estimate or any other aspect of <br />this collection of information, including suggestions for reducing this burden, to Chief, Information Policy <br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; end to the <br />Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. <br />General Instructions <br />li.:If form has been partially <br />ready preprinted. <br />completed by preprinting, disregazd instructions directed at entry of that information <br />2. Enter 'Permittee Name/Mailing Address (and facility namellocatign, if differenQ," "Permit. Humber," and <br />="Discharge Number" where indicated. (A separate forth is required for each discharge.) <br />~; 3.,Enter dates beginning and ending 'Monitoring Period,." covered by form where indicated. <br />y; '' . <br />E ` 4.-Ekttei each "Parameter" as specified in monitoring requirements otpermit. <br />-5. `Ente'r "Sample Measurement" data for each parameter under "Quantity" and "Quality" in units specified in permit. <br />i• ~ "Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements <br />Sor each parameter obtained during "Monitoring Period'; "Maximum" and "Minimum" are normally extreme high <br />1 and,'ow measurements obtained during "Monitoring Period." (Note to municipals with secondary treatment <br />I; rCquirement: Enter 30day average of sample measurements under "Average," and'enter maximum 7~ay average <br />of samplgmeasurements obtained during monitoring period under'SLfaximum. J <br />;8. Enter "Permit Requirement" for each parameter under "QI(antity" and "Quality" as specked in permit. <br />7.dUndfr "No Fx" enter number of sample measurments during monitoring period that exceed maximum (and/or <br />;men/mum or 7-day average as appropriate) permit requitement Cor each parameter. If none, enter "0". <br />f:-$. Enter "Frequency ojAnalysis" both as "S'ample Afeusultinent" (actual frequency of sampling and analysis used <br />E ; 'durin`g monitoring period) and as "Permit Requirement" specified in permit. (e.g., Enter "Coat," for rnntinuous <br />motdtoring, "1/7" for one day per week, "1/30" for oneday per month, "I/90" for one day per quarter, etc.) <br />:. ... <br />nee{ "Sample Type" both as "Sample Measurement"gactual sample type used during monitoring period) and as <br />Permit Requirement," (e.g., Enter "Grab" for individeal sample, l4HC' for 24-hour composite, "N/A" (or <br />' continuous monitoring, etc.) <br />~Q' Where violations of permit requirements are reported;:a(tach a brief explanation to describe cause and corrective <br />Y'; fictions taken, and reference each violation by date. <br />R.3 L <br />X41. -(f "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry. <br />~,~Enter "Name/title ojPrincipal Executive Officer" with "Signature ojPrinctpn! Executive Officer ojAuthorized <br />t«P. 'Agent," "Telephone Number," and "Date" at bollotp of form. <br />~~, Mail signed Report to Office(s) by date(s) specified in pern»t. Retain copy for your records. <br />I ~. <br />More detailed instmctions for use of this Discharge Monitoring Reporl(DMRJ form may be obtained from Office(s) <br />specked igpermit. <br />g. <br />`a; : Legal Notice <br />Y.' <br />~• ., <br />r+~port is required by law (33 U.S.C. 1318; 40 C.F.R. 175.27). Failure to report or failure to report truthfully can <br />to civil penalties no[ to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525,000 per day <br />0 olation, or by imprisonment for not more than one year, or by both. <br />~~= <br />E ,Form 3320-1 (Rev. 08-95) <br />~~:.. <br /> <br /> <br />