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Paperwork Reduction Act Notice -
<br />n.al_!iC riCi~. ~.`C 6...., , .,ice-,. ,.~ :. ~..-....... C.. ~y ,-. r,..,.tr _..I 1„ L,,_. r..., .",
<br />_.-..___... _... .. .. .. .. _.._-.[~~. use ar.
<br />...., ~gc per re..rua:e for some mi:^.or facilities, to 110 hours a. wn everage pe* response for som= n~~ jet fa:ilities.
<br />i with a weighted average For major and minor facili[iex of I B hours per response, including time for reviewing
<br />instructions, se.^.rching existing d.^-ia raurces, gathering red tnxintatning the data ^e::tJed, and comp!et;ng and ;
<br />,...,,.:.n _....
<br />--,~°.. g Lho co!hx:ice. of infn,^.nati^.^.. Send comments regarding the border. ~~t~mate er ary other a~~,:,;.t of
<br />' t1,a cullu,tiuu of iufui metion, including suegesuons for rulucing this bw din, to Chief, hlfo, uinGuu Fulicy ~
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, SW Washington, DC 20460; and to the ~I
<br />~, Office of loformatioo and Regulatory Affairs, Office o(Management and Budget, Washington, DC 20503. '~
<br />General Instructions
<br />1. if furw uan ueeu par iially Wmpleled by proprlnling, dlsregdld tnsiruc[tons dii 2u,iu) at entry of ihai info, u,niiuu
<br />already preptw[ed. -
<br />2. Enter ~PPI7ItC(PP ..^.rnme<t!oi!,ng .4ddress (and facility [tame/location, S different)," "Permit Number" and
<br />"Discharge h'urnbrr" where indicated. (A separate torn[ is required for each discharge.)
<br />3. Enter dates bcgtnn:ng and end! ng a Innunrrng Perrod"covered by torn[ where indicated
<br />a. Enter inch "I'nrunn•rrr" ~s sps~fl,_d in monuoring requirements of permit
<br />5. Er!cr "A'rrmPle .Vvo a,ramvnr" data fw cash parameter under "Quanhn." and "Ounlity" in units specified .n permit.
<br />":h-rrotm" is norm~!Ip an~hntr!ic a~~cragc (gcnmctnc average for bacterial parameters) of all sample m;.zs ~remenls
<br />for each parameter o6'ainr•d dunn/; ' t h,nrn,r,~nr+ Prru,rP'; ",4~axinurnr" a:,.^. ".1lvn,mm~" afC nOrmallY c;:: ~c,ne high
<br />and lots measurements obtaircd during ".llunnunn~ Period." (Note to mun.~apals with seconca;; treatment
<br />rcgwremuu Lnt,.r iu-d:,y JlClad.; ci uirp;c ai~.;,,.icmentsunder ".ii.._,,.,~ _ -alermaxim~.~ "-nay average
<br />of sample nteasurcmcnls obtained during mondoriog penod under "Alru-ioenr--.)
<br />o. Enter 'Tenor[ Rcymrrne•r.r" fc s;ch. p~:;a~cis ends "(%uanri;y" and "Qrerity" y spe:iGed ;u perrtil.
<br />7. Under "An F]" enter uuwbu of unipiv uic:uuuauiLS ~',.,~ng munnuri,g;'~eriod that escx::.~:a.num (and/or
<br />minimum or 7-da} ateragc as appropna:cl perm![ req.:c~r.:c^~ ioreach parameter. If none, enter 'C .
<br />B. Eider "hrequencY ,+l Analt~srs` both, as '•xunple iirmmmen(~ lac:uai irequeuel of sau,pl,.,g ,::~~ ui,dit ss used
<br />dunng n:onitnnn;? period) and ati 'Pr.°n!~' Reniar-vnrvnr" soccifin !~. n~rmit (e.g .Enter '~'un1." for commuous
<br />mouuoiiug. "/. %~ for uuc cvn~ pu tve~i.. .:b° iv. ui<,:.., pct ;+,~•i::. ~~,~ ..~~t d r. p..:,.arter, et: )
<br />9. Emer ".Sample 7tPe" both as ':Son;ple .l!cu.,ur~;ne^u" (actual sample :; '•~sed doom;; mnrnonng penod/ a.^.n ._
<br />"!'erne: Kegnrremcnt," (c. g., Enter "Grab" for mdnidual sample, "?a%It"' for 2J-hour composde, ".\':1" .'o:
<br />conunuous monttonng, clc )
<br />10. Where violations of permit requirements arc reponcd, attach a brief esplanauon to describe cause and correcuvc
<br />actions taken, and reference each violation by dale.
<br />1 I. If "no discharge" occurs during monitoring period, enter "h'n Discharge" across form in place of data entry.
<br />12. Enter "Name/Tirle ojPrincipnl Executive OJTcer" with "Signature ojPrincipnl Executive Officer ojAu(horized
<br />Agent," "Telephone Number," and "Dare" at bottom of form.
<br />13. Mail signed Report to Ofilice(s) by date(s) specified in permit. Retain copy for your records.
<br />l4. More detailed instructions for toe of this Discharge Afoniroring Report (DAIR) form 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 S 10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />of violation, or by imprisonment for not morn than one year, or by both.
<br />EPA Form 3320-1 (Rev. 08-95)
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