|
Paperwork Reduction Act Notice
<br />Public repo :ing hui u'ca fu. ii,is eulleciiun of information is estimated to vary r.u rn •, ram_e ^F IO hnurc ac an
<br />average per response lot some minor facilities, to 110 hours as an average per response for some major facilities,
<br />wit)i a weighted average for major and minor tncilittes of 18 hours per response, including time for reviewing
<br />instructions, searching existing data sources, gathering and maintaining the d2fa need, and eemplc[ing and
<br />reviewing the collection of information. Send comments regarding the burden esti ~°te or any other a;"YCCt o.
<br />this collection of information, including suggestions for reducing this burden, to Chief, Info,uuiiun Policy
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washingtoo, DC 20460; and to the
<br />Office of Information and Regulatory Affairs, Oftce of Management and Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially rnmpleted by preprinting, disregard instructions dirccttd.at entry of that iufurmalioo
<br />already preprinted.
<br />2. Enter 'Permitter Name,:LfailinR Address (and facility rtamellocatinn, if diRerent)," "Permit .Number," and
<br />"Du~chorge Number" ~~ here indicated. (A separate form is required for each discharge.)
<br />3. Enter dales beginning and coding ".4lonrtoring Period" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requiremenLS of permit.
<br />5. Enter ",Sample AleosuremenP' data Cor each parameter under "Quantity" and "Quality" in traits specified in pemdt.
<br />"Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample measurements
<br />for each parameter obtained during "A-lartiloring Period", "A4aximum" and "Minimwn" are normally extreme high
<br />and low measurements obtained during ",Lloniloring Period." (Note to municipals with secondary [reamtent
<br />requirement: Enlcr 30~ap average of wimple metvsurcmcnts under ".4vcroge," and enter maximum 7~ay average
<br />of sample measurements obtained during monitoring period under ",Llaxirnmrr.'J
<br />6. Enter "Penni! Requirenren!" for each parameter under "Quantity" and "Quality" as specified in permit.
<br />7. Under "Nn Er" enter member of sample measurmcnts during monitoring period that excarl maximum_(~rtd/or
<br />minimum or 7-day awragc as appropriate) permit requirement for each parameter. If none, ewer "0".
<br />8. Enter "Frequency cJAna/vsis" troth as "J'mirple ;vleasurinenl" (actual Lcyueuc} of sampling and analysis used
<br />during monitoring period) and as "Penult Requirement!" specified in permit. (e.g., Enter "C'nnt," for continuous
<br />monitoring, "//7" for rate day per week, "1'30" fo: env dad p=: month, "I/; 0" for cna a°°~ p;.r quarter, etc.)
<br />9. Enter ".Sample Type'' both as ".lample ,Lleacuremenl" (actual sample type used during monitoring period) and as
<br />"Permit Requirement," (e.g., Enter "Carob" for individual sample, "24flC" (or 24-hour composite, "N/.i" for
<br />WuLiuuuus uwuiluring, clc.)
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />actions taken, and reference each violation by date.
<br />11. L` "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
<br />12. Enter "Narne/!i!!e oJPrincipa! Executive Officer" with "Signature oJPrincipn! Executive Officer ojAuthorized
<br />Agen(," "Telephone Number," and "Date" at bottom of Corm.
<br />13. Mail signed Report to Office(s) by date(s) specified in pernrit. Retain rnpy for your records.
<br />14. More detailed instructions for use of this Discharge Afonitoring Report (DA~IR) form may be obtained froth Office(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
<br />result in civil penalties not to exceed f 10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day
<br />of violation, or by imprisonment for not more than one year, or by both.
<br />EPA Form 3320-1 (Rev. 08-95)
<br />
|