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~~.~„~,~~~,~,~.~, ~~=.~'-,-~-:~ ~~n .Act i~totice
<br />Public reporting burden '`or this collection of information is estimated to vary from a range of 10 hots as an
<br />average per response for some minor facilities, to 110 hoi s as an average per response for some rajor
<br />facilities, wife a weighted average nor major and minor facilities of 18 hcurs pcr response; including ii-ne 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 Stanch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S. W.
<br />Washington, DC 20460; and to the Otfce of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />general Instructions
<br />I. If form has been partially completed by preprinting, disregard instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Perm%ttee NamehVailing AdJress (and facility ^ame/location, if different)," "Permit Trurn6er," znd "Discbargz
<br />Numher' where indicated. (A separate form is required for each discharge)
<br />3. Enter dates beginning and editing 'S'vl.nil~rilrti Peri~.l" covered by form where indicated.
<br />4. !;rifer eaci7 "Params[rr" as specified in monitoring rcquiremenb of permit.
<br />5. Fn:er "S~rrrl,~ ivl~.esurz.~a,t" dcra rnr each parameter under "luau:%r„" and ~,ralih~",ns spcciFicd lit na. ~nii. "Aw..ge" is
<br />'n Orntray arithmetic z,•_ragC (t,COill„inC i!\'erJ ~,l, fUI iL'Cie'l Fl pJ., .. ~1]CiCi N) Uf all bari.lllc C'CaSLL-e mCPLS .Ol G7Ch pa,:tmeifT
<br />cuu:incd du7i~;g "ild~„r%'~ria~ Ili- ~"; "tl.r.il„rrnl" rnd ,;;i,lil,rvm" a,c no~.~ ally c::~~.:mc hib, ;.rid lo.: measurencPts
<br />obutine~ doting "iv,-,nit~ri,rd F-'ri i". (~otc ~,. n .rt c .:1~ tv~''l ~::condar,~ ircah+trnt r,;ui:cmna 5nler ~~-day etc e6a
<br />o'sar.n'e mcrsu.cmcrrs unccr '~:. -, i,;. "m"1 enter r.l~tt rum 7-d:y avenge of sum,-.'c me^SU:cm~, tc a`.L fried d.1;r'g
<br />monitoring period under "ivlaxirru,::.")
<br />u. n,.."~'„I,:[2•;t~i,r„r.~at"'°crtach parr^.ri-rurn'_'~ ;';.),"c-t_"zn,,lifi"asst~,cl~!~uinp.rmi..
<br />7. ..-~er,..r..F~:"F. deraumbc~.o''sarlle~n.ru;;-;~~~ '.~nrg,~'o.t~''.rin~; nocG ~t~;c~:dma~ii~~wr(a,d~e*min~r'l.in
<br />o- 7 d.y a(•e cue as a.,propriaie) .rmi~ r~q.'I ~, nlc-,I Gn .e' S ; _ :.o~erer. If ~nr :, ca:e "0„
<br />8. ?n,._ "6; =~,. „_~, ,:.. ~ ,t,sie" i : l .. "5. , ' • .' .. ,,, „ ' (acfJ..' ., r;' u,r u' ,~- „~ a'7d rr.cl.'sis cscl d.,~cr~
<br />iT1VP'.Jr ~ rC~-DC~ tpr~ fiti' .. ~li n. 'l'll.'1,~:. ... ?i"(. ai i "' tKt;77' a.g. ~:I:i' ~ •~/, ,• fUi CO! I: 1u01 ~ n'0'1 ~i('i'~~, '[~7„
<br />fs nnc da, pc: v;cc'c "1/30" far r.n~ rlnp rs monr',, ;;'40" for r, z d'`y pcr gcr~n, et_ ,
<br />~. Nu "S;,;y I, T~.-_"hol'l is "S.%„vl, ,:.. _„ "(;~_I•~d :.:,r~1;: ttii~~ a~cd r rainy mcrutorino ~:_ricdi r~~,d a.~ "F..r~tli!
<br />!v.lt~i:-rzr,l:r," (c.~. "nlcr "G-_~i" .o; ;,:ditid~:rl ,anpla, ^7,;,/; fc: 24-`n _r composilc. "4.:!~:"•~.: con:~nc~r's
<br />monitoring, etc.)
<br />10. F," ..;re violation; af;,_mi: rcqu~.:mcn~~ . r; r,c:'u', :l:C'J,l a 1-"ic't:plrn^liu 'o c':~clihe ceutu arc; ccrx~~vc ~ tion::
<br />to be [a;en, aid rcLrencc cacL• violation by date.
<br />t i. Tf "no discharge" o::curs during in:rr~:orin~ p.:rclr. ut._r "~'c "i~c' r-bc" rrrrs ;o~--, in plae_ afcata cnLy.
<br />12. En.cr ",\ltmz/Til1= if 1-i-iu,%rui F.':~.u~ire ,,j~';, ^ri'h "Si,,,,aru;e ~y~F,}r. i,-~' r:.,.raiv-• GI,`'i:•,., ~f A.u;eo,-i-r.,t
<br />Ab~~n[,""T~l~plnnsT~4r,nlsr,"and "L'a[,:"at bottomuffonu.
<br />3. Meil sibmed Repoli to Ou9ce(x) by date(s) spccilicd in Hermit. 2ctain cop-; foryaurrccrds.
<br />l~l. Vore detailed instructions far use of this Ltr:.'r.r,~s :!;;%,ai,~ri,r„ k;c;rr (L~TJ Tenn may be obtained from CtTice;s)
<br />specified in permit.
<br />Legal I~lotice
<br />This report is tequtred by ]aw (33 U.S.C. ] 318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in
<br />civil penalties not to exceed $!0,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not mote than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03!99)
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