|
P:: ~erwork I~educ~'or ~.ct 1~Ioti~,
<br />.ling burden f'or this collection of information is estimated to vary from a. range of ]0 hours as an
<br />er response for some minor facilities, to 110 hours as an average per response for some major
<br />with a v/eighted average for major and minor facilities of ] 8 hours pcr response; including time for
<br />tng instructions, seazching existing data sources, gathering end maintaining the data. needed, and
<br />eting and reviewing the collection of information, including suggestion for reducing this burden, to
<br />Information Policy '3ranch, PM-223, U.S. Favirottmental Protection Agency, 401 Iv` Street, S.W.
<br />ngton, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />rt, Washington, DC 20503.
<br />~~ ~~ral Instructions
<br />1. If farm has been partially completed by preprinting, disregard instruction directed at entry of that information already I
<br />preprinted.
<br />2. Enter "Pen:rillee Nomz/ivlailing Aa.~ress (and facility name/loeation, if different)," "Perini! Number," and "Discharge
<br />Numtzr' vrSere indicated. (A separate form is required for each dschazge.)
<br />3. Enter dates beginning and editing "N/onitcrin6 Yzricd"covered by form where indicated.
<br />4. Etter each "Pm•,~!ratsr" as specified in monitoring requirements of pet-mit.
<br />5. Fr.icr ",S.,n/!. ,L,'..;v+~r.~rrerr["date far etch parameter under "~lrs+uiq,^ and ~.rralitl~" as spec, led in pemlit. "At 'r~y_"is
<br />r:~.,n~1ty ;.,-lnmet r ;:verrge !geometric uren•ge for bacmri:.l parameters) of all samnlJ I-~easuremel b for each pa^vneter
<br />oh+~lncd d,ning °:1 ;r%r.rin~ I"!"iiJ'; '..rirrr„r" Pnd dli!rinrum" arc no-nIIlly erii~Cme high and loan measure:acats
<br />J';.::.Illll r4U`~0~ "ni'.Jli/9!'lirb PariOC+". (Nntc lD nlUll!CIp81S Nlil tiLCOndar}' irCCtrnLPi ~C~lllCCmCn.: 1:Dicr 30-daV :~YO.~gC
<br />of ~;:.r,,'c recasmcments utdr "f.v_,~.r,;_,"and aritr r.•.eain~lum 7-day avcrzgc afsamplc mensur.mcat, obtained d'~riag
<br />nr,itoling period under "iviaximtrm.")
<br />L. [=~i'~ "i ,::/fit'. !q.'Grit',ll" 0"CUCil p; is mCier L`:G: "y`:e .~r%i l''.~~0 "t UJ ~lll'"£S S(:'C:~ICI ~P ?E:7r117,
<br />7. !; ~i , ' i;,~ r " . ~ICr numb.. o" .~ aple men5uwraent derirg ; rctit;r ia~ p• rDd t'-± ~_ae,I mar, rlum (and,or ra~n'.r.nm
<br />C' ~-d:, altii'y., i~5 r77r0'i-:iii) p2rnllt rCi111ifmET11 fUr C^c ^_It n~i1rQC~C~. 1f rJrC, CC'tC- "17".
<br />i''. .. "': j 'n ~r;•e a" bath as "~. ,,~ 1~ ~v~llcr!',...', r„ (:,; ul~'. frcgc _rc, , ' s.,r.~riirg and an,dys's •_sec' during
<br />~cnih•~ ~ r; pcl nd'• ~ ..I us "f:,;.ri1 R:_ler._ n „r" •~•cc;fcd .n l,cnnir. (c.g. ~ .., . ,.. r.'";c: cenlinucus moniir,,in;;, "!/7"
<br />.~_~ :~r. da} ir.- c.':, "!/.ID" for one d.¢y ~~r Ir:~nat, "l:v(I" fnr o~~„• ri~ay pa gadrtcr, c'-'
<br />c. , r, T;• "!>oth es "S .,.11. ;;, .; rr.:"(_etrurl sort plc tyre ~_~.d c'.urin3 menitD,ir,; perori) a^c: as ". _,-,ni!
<br />I1°;;, ~.,r.•I!" (o.;,. Suer ";;nl" for indi',;dr'.1 .tn1:Ic, "?-;;', fri 24-!•n. er,r,pnciic. "\!:4" fJr eominuous
<br />manitaliug, etc.)
<br />1C. Ch:ra v;e I; t~o;:~. o°;:crmii rer]UC,-arac~t, arc ~Cporte.t, n;;.a,•h a 1- i,' e;:plsn .tin- to d„•~c: ibe co~sc and correctir~ cclions
<br />.a ha t~':cn, ;,nd refen;nce each violation by date.
<br />t 1. :'"uo disc 1~;,,,;" c_cu s drr:nU r,oaii, rang l,,;riod, cater ".do t)iad-z.rge" : r-ress tarn in p'u:c of tiat.^ ~n'.;~.
<br />1''. ?mcr "iV_uno;i:'1 -~`,"r%.r.:r}: c! F.c"itri,;: ~~1'-. r` •.vith "S%,;r.-Ile/_' Oj ll7r,_i~,d L•s__-1~^vr C,;ri_dr rJL;!!;r,:iz_!
<br />rie.7d, °"TS1G/%IndrS,Vn,7t.'r,"ard "Csle" at bottom of form
<br />13. U,ail signs.'. 2eport io Of;tcc(s) by date(s) sgceilicd'n permit. Retain copy for your records.
<br />14. More detailed instn:ctiens `ar usJ of ftis Tisau~b. 1v;~.ni!,rbro 1~:~~;T ;C.'~IF<) tone ma}' be obtained Fran Ci~Scc(s)
<br />specified in permit.
<br />Legal Notice
<br />lltis 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 pcr day of violation; or in crimival penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
<br />
|