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mss, ~,••~~rl~ deduction 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 />Creneral Instructions
<br />1. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information already
<br />Preprinted.
<br />2. Enter "Permittea NormhLlailing Aflress (and facility name location, if different)," " Permit Nu,nber," and "Grschsrg~
<br />Numhzr" whets indicated. (A separate fortn is required for each discharge.)
<br />3. Enter dates beginrting and editing "Monit ,ring Feri ;J" covered by form where indicated.
<br />4. Enter each "Param~ta~" as specified in monitoring requirements of permit.
<br />5. Enter "sJ,,rPrr A1_ a.cros,r_n!" data for each paramctrr under "~wnti!)~"and litnl%~)~" as specified in permit. 'Ardr,os" is
<br />aorntally arithmcGc ave~~ge (geometric average for hacteri,l narameters) of all ssmp!c measurements fur each par.,,neter
<br />cbk.+ned during "4f :;n :;ing F~rbJ'; ;Llltimmn" and !/Iininnun" arc uormclly ~~ romc hip~t and Irnv measurements
<br />nbtrincr; durng "1;• r;F„±,ry P~,i-.j". (t:o:e to muriciials t.irh secnndar;~ treatment r~cui-emeut: inter 30-d.^.y avt ~;;e
<br />of Sar~p'c tnwstccmcnt- c-:dcr ",;:~~rlbr," rd enter :~:~ximum 7-stay acetage cf.~em~lc me~suremen[s obtained iluriag
<br />monitoring period under 'SYhrimert.")
<br />fi. `;alz: ':°ervai! Rs;*ui,-t,;u,;r" '~,,r esch pa^met.r un~ z,- ";;:rlr~+;rp" rn3 "[uali~" a sn~cifie3 ;r permit.
<br />7. ;,'ndcr "A', F_r" e t+c- num;~s of sa-~'c c-.:asuremc,r di r;~g to-'t~ :nC ;,c^od . a czcxa rr~r>; i nuns (nod cr mintr;ur,t
<br />c- 7 dry a,~c,-cgc r; ~ ,nrrnrrae) r~ nit re.,v'remcnt f,r each nar:tmct~r. 'f none, enter "C".
<br />^. ?n;r: "f7.,~:•_,cy%f 'uotys::" a: t': nc ", _ _ ,,, -. . _,,. "(,t_tuel frcr ucse c"s~ an;ing rtid arutiyss nscd dcr~ng
<br />monLatingpct'.ud).,:•'~s"P_,,~,ilR,..ui,vi,'_•r,("snc,iG~:d.nt;crnti'.(~.,r,.~nlcr',.a,rr," crco l;.uo.smcnilmia;,,"1/7,.
<br />ter onr_ dal ner r:zc'.~, "!/30" for c tc Gay fzr mun+h, "1/90" for one d:.y per quzrtcr, etc.)
<br />S. -n'e- 'SS.,a; '_ T;/~ :.otl, as „~~„n-1 e ,_ -s,,,-~,,,:,,•" (sets:' sa~r; :: IyT, as'd ~ o i..g m niiturin; pe.iud) and s ",^1 rr,;;r
<br />~Z~;.rrti,-e,u~a"' le.g. ;'.ntcr ":;r_~h" fur i~:dF:idual s.;~a,ac, "',7r fir 24-ho_r cnmrasitc, ".VG:" for continuous
<br />monitoring, etc.)
<br />1C. ^.'hcrc violations of permit rcquircm .n'=, ar r~no tee, ;:rash a Lric.'c..p!:.natiu t to d_scribu c::ast end cunc~tive actions
<br />to be ti~ceq and reference each violation by date.
<br />t t. 7; "no di~cltarge" occurs during monit;, ring pond, enter "vo Di~chzroe" ceross form in place ofdata e :1-y.
<br />IJ. Enter 'iVom~/Titl_ %f I t-Irr;;,^]: £::: s%tiu elf.': ~" with "Si.;nolrnv of Prn:.:i,-,! E.re_zrtn~_ t~~.~r cJ Aut;r.;-iza„1
<br />ti gear, ""T~l~phar ~ P.kunF", "and 'T,or~ " at bottom of form.
<br />13. P/fail signed Repcri to Cflicc(s) by dote(s) spcciCtcd in permit. Retain copy for your records.
<br />1~. More detailed instructions for use of this Dis_kar~z ;r1~,uir.ring R.rF%rt (Cl~1F~ farm may be obtained from Otlice(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 131 S; 40 C.r.R. 125.27). Failure to report or failure to report truthfully can result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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