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Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an
<br />average per response for some minor facilities, to 110 hours as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 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. Environmental 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, disregard instruction duected at entry of that information ah-eady
<br />preprinted.
<br />2. Enter "Permittee Name/Mailing Address (and facility nameAocatioo, if different)," "Permit Number," and "Cischarge
<br />Number" where indicated. (A separate form is required for each discbazge.)
<br />3. Enter dates beginning and editing 'SL1r.nitoring Pariod"covered by form where indicated.
<br />~'. Enter each "Paronreter" as specified in monitoring requirements of permit.
<br />5. Enter "S_~mplr i~lasurerlaat"data for each parameter under "Quantity"and Quality"as specified in permit. 'Avrroge" is
<br />normally arithmetic aver age (gcromerc average for bacterial ~aramelers) of all sample measurements for eacb parameter
<br />c'.:taincd duzno 'SYsnit„ring Feri,d'; ";/1.uimtrt" and hliui>,nun" aze normal!y ex7eme higl-. and low measue~-cn+~
<br />obtained during "; d~nitsri:rg Period". (P•'ote to municipe!s tvitb secondary treatment rquirumelt: Enter 3C-day average
<br />of sample cuasuremunts under "Acsl~b•~,"md e;,icr ma,cimuT 7-d<y average of sa-~ple measermenL obtained d,u-:.:g
<br />monitoring period under "i/„uimum.")
<br />J. Gnil'~ 'i'~CI-r,::~ {i,: ~1!L7::1 _'.:i'r ~':i ezc:~ poramc+er under "~L(JI/71 C~" FIIG "~IIQhI~,"a5 spccif ed 1'1 p:,i~illt.
<br />7. Jr.d_r "F', •'i " c ~!: r ~imc-; cf s.~ ;~; Ie m~asrreneT dt!~ng monitorn~ _riod [ila? e> cert n-_•in-r~m (:nd'r•r min' .:n
<br />o~ 7-fey a+'c :ae a. a pr~pri~t:; permit rLquiremcrt for czch parameter. if none, ent.: "0".
<br />g. :nler',^r °,~, _~i_; .~' ~_l, ,::" ~~,•~ °s "~ll;tr (d lvl--~~In~~ia::r" (act. al f:.gc:ncy of sr~npli ..•ad an~'J sus !sec i V_fi,i~
<br />,nonit~,in„ p~.ini) ._ _ es "F_,.,r! Raj,,ir_,i:_,It"spec:fied in pairnit. (c.g. inter ""0:11,"fnrcunt~nuo~~s monitoring, '7/7"
<br />rr en.: dry pzt vre';, "1/30" Foy one day per month, "1/90"for one day per quarter, etc.)
<br />9. 3nfzr "S.~•r;-1_ T Ir"'nul'l rs "S?a r!s i :•'., ,s,rrr:aert" (actual sample Yype used dur nrg monibJri e~ pLind) and cs ", , r,.i.
<br />2yui.•~,.1:,,,," ( C Pn,.r ",.r./." for individual s~uroplq "24H~" fnr 24-hcur compcsite, '?U!." fur co„'',uoas
<br />monitoring, etc.)
<br />]0. `:tier: viola'i;,r: n`,enn;f ee~'~amerts an reported, rttacb a briefexplanstinn rr• cesolibe cacce :~d corrc;'vL ;.rtions
<br />to be ta.';en, znd reference each violation by date.
<br />1 1. 'f "nod'>c;l~ ~~:" nc_: ~.-. du.-'ng **'nc'b.ing perod, enter "No C~sci»rgd' across form iu plr.ce o"ci? ~ e.~'~y.
<br />1Z. :.nte- "i~'~.:re,%;ae cJ• "-i,r_•~},1/ ,~r~_utire Gy.~r" with "Si,;a~urrt of Prirrlra/ rcas•tiv~ Gyre°,~ o,',~l,lrt„~:•:~'
<br />Ag_ r7t, ""Telrp;to,le T.'ul;rl-e•', "and "I%ute" al bottom of farm.
<br />13. .:c;t si~~cd Rc,. r ; to C "'-ce(s) by ~te(e; spcciGed in pcr~nit. Retain copy for your records.
<br />14. :%cra ~Lim'cs ins~~lcGons for ~ .~ o't`'s Cischlr~e ,Y;•,aitorirrg R.•r•,rt (C,LII~ form m_y be obtiincd fro.. Cl lc-s;
<br />specified in ,rcrmit.
<br />This repori is r~quced by law (33 U.S.C. 131II; 40 C.P.R. 125.27). Failure to report or fai]ure to report truthfully can msuh i.:
<br />civil penalties no[ to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of viosLo^.,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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