|
Paperworl~ ~w~u~~,~~n Act Notice.
<br />I Fvblic reporting burden for this collection of informaticn is estimated to vary ;rom a range cf 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 dais 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 Infoirilation and Regulatory Affairs, Orrice of Management and
<br />Eludget, Washington, DC 20503.
<br />general Instructions
<br />]. If form has been partially completed by preprinting, disregard instruction directed at enhy of [hat information already
<br />preprinted.
<br />2. Enter "Pennittee Name/lrfailing Address (and facility name location, if different)," " Pennil Number," and "Dis.:lrarga
<br />Number' where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dats beginning and editing "Monitoring Pari ;1"covered by farm where indicated.
<br />4. Enter each "Paranu_t~r" as specified in monitoring requirements of permit.
<br />5. Enter "S.rnplu i/i_asur~nrarr" dzta for each pammutcr under "! u~n!i.7~" and rnr~Y!~~" as specified in permit. "Arrr rge" is
<br />normally arithmetic a,•erge (geom. b is avcrrse for bacte=al par+nerers) efall sample measurements for each parameter
<br />obtained during ",L1.;,!r•,ri,;,; P~ri;l"; "td_sir,+.nm" :.r,d i,li,ri„vru;" arc no-rnall, c, ,mr big;, and lot. measurements
<br />obtrinei dwi-g " '•.rrn.ri,g f ~, i•.+". (`Vote to mur;ci; GIs c'Ji tie.onc;a,~~ tr:arrn~rt r_.•uircment: ;_~-~ter 30-day avr age
<br />o` szmnlc mcasu-eme~« under "A'Ja~'J and enter -,rx~m::n; ',-dry average of sr.~ri~'_ n esuro-ncn`s obtained dur;,.t;
<br />monitorng period under "ivlariunrm.")
<br />6. col,:-"N~~,i,rilRr~uL~~n':,t"rnrcaehparamc[crund:r"Qu,:~ti!~,"sad"~uelirv"ESSp.:ri~i~..dinp~r~iL
<br />7. ;irdcr " ;'.. F.;" c~,t_ r numbc- u; sam-'c r.ca^wumr.' •irring rc.~;' ~ inv ~ ~:r' ; _~ , ~.crcc r,~a:~.~nwm (and,br r.ii~,~,nur
<br />cr 7-day a• crag.: rs t.proprirtc) remit re-iu~rnn~at fu. _~_i, nammctcr.:f none, enlcr "C"
<br />~. ::,rtc~ '; 'r •,r1,t; ~ t,(,,1/acs;.' both as "P...r+~!. ,bf.• _,...,.~" (.rctual frcou.ro:y o'ti_n,l'.ig and an d;sis used rtu-i~,g
<br />monilnrt-.q re;iod) rn^ rs "Ps,::i! li~•_Iuir, u' r,!" s ;uafi~d .n ::rani'. (c.g. ':'ter ""•.nr." hn co•,t: iaaus ;nenilerng, "I/%"
<br />fcr one day i,;-,;.al:, "1/30" fcr o.rc day p^_r :,punt;,, '7,'90"for uac ci n~ per yua~.e . ~'c
<br />^. 1=, t.~ ",~~n:,-', T."i ' ;;c', :s "S~„rl•la ~.; °_ . , . ' (zcl'~:,1 s.,r r.lc ~ypc vs~d during, r,ooib' in,; ,e~ioaj a* d as'r.•,r,rtr
<br />R~•arrir~r,:a,r,:' (c.g. 'inter "(i%V."' fur ;rd:•.~dur'I can~'= '?-1//~" .rr 24-~ oru:cmno5ile, ",\r//" ;nr conLnuaus
<br />monitoring, etc.)
<br />10. `^ccr,: violatior+s OTpe~rtit rec.uiramcn', ar_ .,:rn ic', altnch a I; ic"~.:-!sna'ion to dcscriSe cause and eorrzclive uctioas
<br />to be taken, and refcreoce each violation by tla~c.
<br />11, Tf "no discharge' occurs dur+mg monitories pcr.a'., enter "\m Discharge" across form in place of dctz ent!y.
<br />1_^^. Pinter ';lr~m/Tltle rf l+:rt•ird r_'zr!i,~~ :/'i. a" « itir "Si;;r,lll:r.t ,Jr /err:t ii~l rix._rtli•'t Cf7i__w of A~Nk%,•iza.
<br />Ag.:ut, ""Te1~•plmn ~ Alwnt~,-,"and "G~r,:"at bottom of forma.
<br />I3. email signed Report to Cfiice(s) by date(s) specified in p=rmit. Rclain copy fi,r your rxords.
<br />lei. Viere detailed instructions for use of this Dis~;rsra ~ h;onira•ine Red •,rr (I-i~ITrj form may be obtained from O^ice(s)
<br />specified in pemri[.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 1Z5.27). Failure to report or failur to report truthfully can result in
<br />civil penalties oot 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 year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
<br />
|