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~ Paperwork Reduction Act Notice
<br />' Public repoRin¢ burden Fnr thic rnllnrtin~ of ir,(n•matina i~ c;tirdL:u ;u .~:. s .. ~. r:;.-.~-- - ~ ~~ ";.,. I~
<br />~. .. .. ur; a+ .r.
<br />_. _: _o~ p.: r,_;poasa ;,,: ,vu,c u,.cut iac+ii[ies, [o t t0 hours as an average per response for co.mr mnjor faeilaies.. ~'
<br />~ with e u•righrrd aversgc fur m:.'}a[ ::r;d minus f„ciGtics of IS hours per response, ,ncluding tune For rrview~g '
<br />i insU-uc[ions, starching er.isting data sources, gathering and maintainiag the data neerlrll, a_~d completing and
<br />reviewmc the collection of inForma4nn. Send commrnls regarding the burden estimate nr Ary other : ,i,xt of
<br />i ibis collucnon of miormation, includ mg suggestions for reducing this burden, to Chief, Informauou Fulicy
<br />klrvnch, °St-22;, US. cuvuunmeatal Proteaaiun Agtncy, 4U1 M Street, SW Washington, GC 20460; end to the
<br />i Office of Information and Regulatory Affairs, Office of Management and Budget, Washrogtnn, DC 20503.
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<br />General Instructions
<br />1. if form has been partially completed by preprinting, disregard instntetinnc directed at entry of thai iafutrm[ion
<br />already preprintrd.
<br />2. Enter "Permuree ,4nme.tludmg Address (and facility nameJlocation, if different)," "Permit .Number." =;._a
<br />"Di~chargc ".'u;:;5„" ..Lae indicated. (A separate tbrm is required for each discharge.)
<br />3. Enter d.,tcs bcgimm~g and atdut} ".ilnnirnngq Prru„)" covered by form where indicated.
<br />4 Fnter CaCft "i'nrtun.7.i"" ,L~ sp,:afieu m nwlnwnng regwrcments of permit.
<br />5. ~rde; "A'u,npi.• ,ii.•usm c•rnerrr` [l:n;t (Or each parameter under "~lunnnh" vtd "Qualm" in units specified m permit.
<br />":Irera~tir" a normalll arahm~u;: a~uagc (dcanxtric accragc for bacierial parameters) of all sample measurements
<br />for each parammeter ohs :inc.! durir- ".(;nu,on„rti Penu<!"; 't:ar;:nunr" and ".1lirri,nunr" arc nomtallc extreme high
<br />and for+~ mrasuremrnls ob!li red doting ".'„untnu~utg /'rood" (Note to mm~icip:rls nith secondary treatment
<br />rcquircmcnt Enlcr l0-dat nccrnoe nr r,~.,,.!r. r+.:carur.r:cnts :~~~cr " I~: r'-,.. • .a.d ent~•r Inavimum 7-0ay atcragc
<br />of sample matsurcmcnts ob4nrncd durng monrtanng period under ".lfarimum "1
<br />5. Enter "1'rrrnir H~ymren;[~nr" fur such patamdcr under "Uuunutv'~ and "(hrohrv" as specd~c:' ~~^ p:r^ ~[
<br />_ ...u .
<br />7. Under "No Fx" enter number of sample mcasurnrcnts durng mnd~~onng period th:.:.;:c ~..:'~a::imum (arttL'u[
<br />minimum or 7~av arrrng• as ep~•*+pn^.r^~ ; :ni' . ...,.c.,t fr ~ -`
<br />. ':,•.. ~,:. , N.; rams cr li noti_, `iii U
<br />,. ..... ,,,~,r .. ...,,, ,..... ,. 2'7 ~r
<br />% haler "HrP ter!'"t" ~! d. ^!l' I".:•"i :. .... _ .: ..•„'~r.: t1C ..,.. .. e:it: .C~ - ptiiiiiliulg iWd anal\SU nSW
<br />during monitoring period) and as "P. r+uu Prqutn•merrl" specified ur pcmut. (c. e.. toter "['nor," fur cnnli^~tnus
<br />monitoring.:,/,7,: for one day p•-I irec6. ~ I ~ :0" fn; or,;: ~' ;, ncr :rte.-,++ , ^ r n;,' !... ... ,..:v per quari..:.:.I.
<br />9 (•r11Yr "\'nrn+., 1,. T.. [,..,~ "~•_.;:~ .'.i: ,.. ~.. .rbt ,,, „IU il.rl until ~ p -_ g 1i .~.!) -
<br />nc tr c u~~~~: uunn;! monsoon cn_..
<br />"Pernur Rer)utrernem." (c g., Enter "Greh" for mdn'rdual sample. "?aHC'" for '2a-hour composuc. "'~':~" cur
<br />continuotr_s maniinrino, r•Ir 1
<br />10. Where violations of petlnu requirements are reposed. attach a bref explanation to descnbe cause and correciite
<br />actions taken, and reference each violation by date.
<br />l I. If "no discharge" occurs during monitoring period, enter ",Vo Discharge" across form in place of data entry.
<br />12. Enter "Name/Title ojPrincipal Executive Officer" with "Signature ojPnncipnl Executive Officer ojAvlhorized
<br />Agent," "Telephone r~'umber," and "Dare" a[ bottom of form.
<br />13. Mail signed Report to Office(s) by dale(s) specified in permit. Retain copy for yotrr records.
<br />14. More detailed instructions for use of this Discharge A~onirorrng Report (DMR) (orm may be obtained from 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 510,000 per day of violation; or in criminal penalties not to exceed 525,000 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)
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