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~~~:~ ~:Y ~or~ ~~~~c~io~ Act Notice
<br />x
<br />f ublic reporting burden for this collection of information is estimated to vary from a range of ] 0 hours as an
<br />average per response for some minor faci'ities, to 110 hours as an average per response for sonic major
<br />facilities, with 2 weighted average for major and minor facilities of 18 hours per response, including time for
<br />reviewing L-tstructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information, including suggestion for reducing this harder., to
<br />('hie. Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />1Vashington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Etudget, Washington, DC 20503. i
<br />General Ins~~°uctions
<br />1. If form has been partially completed by preprinting, disregard instruction duecte~ at entry of that information aUeady
<br />Preprinted.
<br />Z. Enter "Pmnittee Name/M~iling Address (and facility name location, if different)," " Pzrmil Number," and "Cis~hargz
<br />NumF.er' where indicated. (A separate farm is required for each discharge.)
<br />3. En[cr dates beginning and editing "MoniloringPeri~l"covered by form whom indicated.
<br />?. Enter each "Pmanr~ter" as specified in monitoring requirements Of permit.
<br />5. Enter 'SS.+n[Pk N:.rerrsm~nt"data for each parameter under "~ua7rtin'" and ~u~lig7" as specified m perm t. "A1'2r ~, ~" is
<br />normal}y ariClmctc a1 Braga (geomehic avcr^ge for L•acteriaf pa~..meters) of a'1 sample me~su emer's fur each paramcfe-
<br />ohtained dur~~ ",il~n%;~„•i,to 1'zr%-. ~'; "d/.nimton" e_nd irlini.=n_n7," a~ nominally c;:(-c:ne 'liol and ;uv~ mca5u',:rnent,
<br />obtaincc: deri~R ",ti;~,ni! .,irv~ F,'ri;:!". (1`!o:e to munici.:als rri'h secondary lreatme^! r,.,;csement: Cater 30-day avcaoc
<br />Of Samr1C IDCuSll-ein C.l1.S L~C'CC °/1°2. J'1," 211d C71SCi .'il%R~ nllm 7-dxy al'era~e Of 5':'~n l1C m::aSllrCr10005 0.1t2'ffid ~'llrlrE
<br />monitoring period under "iviarimum.") u
<br />J. .-~.=r'i 279i7!1RLT:!L'b.12,it°fOT CBCh paBmCiCr undei °(i.L',ili(y"u~L "i1; Miry°aS `:pCCillru ~^pzr4'It.
<br />I. I!rldn '::'; E]" enter cumber of sa.^^.le n~:a:urcmrnr d.ri.lp rr,~-'.~ iw ,,-._~oc that ..c~:c ~~~a.imun ;and/or n1i~T'mum
<br />c,- 7 day aaC ~gc rs appropriate) , -,tail regL ~rcmcnt Gtr ~acF parm: tee . If r.on_, Bator "~".
<br />?. ..r1~- "Fr'.; .„_; ',fli;Lllpsir" both s "O '}*.7~ ~L.', _.. _,. ~.v° (.^ciuzl t cc, .. ,.. ~l~lin8 Ord anal;rsis u~td d',ri~13
<br />morfor'g pcr:od) and as "P.•. ,. J! A:au!r_ a _„~" m. cificd in f.r.~ ~ci:. (ag. Grtcr ' . ,,:I," fc°' continuos noniGtring, "[/7':
<br />for one day pe- ~rct:, "1/30" for em: da'~ per month, "U90" for ono clay per quarto-, etc)
<br />?. . cr "Barn; '. Tjr'" !:ot11 a~. "S~„1rL i~'7~ur~,aJo'" (a_tu.! s:.i'ipi. typo us d i l~~i ~~ m~r.iUrin•; perio~~) and as'1'. , ~.r%~
<br />,4r~e!ir.:rt~°7['," (e.~. Lr,le, "G,'_!" for iadi':'idual ,.r-1p'a, "1s1J" fen 2d-'.o:.r composite, "nr/r" for eo'~rnuou•,
<br />monitoring, etc.)
<br />10. C."1cn: ; olatiens cf permit roquircmcnts are rcporte?, 3ttaC11 a bi IL'i E'(I~~i nRt10Q :7 dCSCribC CEU.ti.°, an4 COII'CChVC al':`G'15
<br />to be talcco, end reference each violation by date.
<br />11. If "n0 dlSChai eC" occurs during monitoring pentad enter "No Ci~char~c" across form in place of data entry.
<br />L2. Later "lV.au[.:/Til1a of Fria_ir_i( E~:a:[rriv,: (:~~u'" with "Si~;,;ana~ cj ?'rin'i1~' F'.raulivs O~ •Ur of F.vrha~zed
<br />AK~nt, ""TelrPl:ona Ntrmh,:r,"and "Dalz" at bottom of form.
<br />13. Mail signed Report to Office(s) by date(s) speciGcd in permit. Retain copy for your rttrords.
<br />I~. Mare detai]ed instructions for use of this Gis;lu7gs ivfoni[a-in 11,tF%rt (C,".~ form may be obtained fmm Of(ce(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required bylaw (33 U.S.C. 13 ] 8; 40 C.P.R. 125.27). Failure to report or failure to report truthfully can result in
<br />:ivil penalties not to exceed $10,000 per day of violation; or i^ criminal penalties not to exceed $25,000 per day of violation,
<br />~r by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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