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~~~~~~~~~ri~ deduction Act Notice
<br />:'ublic reporting burden for this collection of information is estimated to vary from a range of 10 houus 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 />L'hief, 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 lvtanagement and
<br />Eludget, Washington, DC 20503.
<br />~®neral Instructions
<br />I. If farm leas been partially completed by preprinting, disregazd instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Permittee Name%Nailing ~Iddress (and facility name/location, if different);' "Permit NumEer," and "Duchurga
<br />NumFzr' where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing "ivfaritorinb Ferio,j"covered by form where indicated.
<br />€. Enter each "Pv-amrr~r" as specified in monitoring rcquvements of permit.
<br />5. Ents S rnrE Iz ,~6s;rsru meat"data far each parameter under "~u_r;rtiry"and Ju~lih+" as specif ed in permit "~Ivr.vne" is
<br />nc~mally arithmetic a~ emge ;geometric av _~age for bacterial paerneters) of ull samp;~ mcsumm~:rts for each pa2mcler
<br />^biaincd dui rg '.r; ,rrii.rino L_•. i-.:f'; ",Lluinsnn" and .'.h'uimnnr" are norn;,lly e;.trnne. hil;]• and la-.v measurelnena
<br />ob[z:ncd duin~ ",...:rli,~-inb ~_•,-i;~". (A!ote to municipa;s with secundzry (T-.Imcnt Ir,ui~ement: Eiter 30-dry average
<br />on sx'~~ple ncasvrcrr:nL•; under ".tiv~r~~ ~,"and enter me•:imu-n 7-cL:y av2ragc ors~mnh mcasurumCn~ obtained u:ring
<br />monitoring period under ",Lfuimum.")
<br />~5. Cr. c: "P~~:r i! H_ mi,~_ra-nt"ror eac~~ parameter u~de; "ir,-;.hn,"and "i~r!~lity"as s ~ecifice i, r:rrnit.
<br />'l. Undo "l,L, dc" e:r:.r m:m~cr o: ,~rraple rr~c:~arc.rnc.~; owing rnouiwring pcr:nd i'r' c~ce:.d n-aaim:m (andlar min! ~ium
<br />aC i-d'Cy :2~rJ~L' i5 a,~p~apn Stf) pC ~nii requli2'; '!. Lt i(]r C::LiI p2Caln Ct~r. 1f II0ilQ Cil.Cr "J".
<br />J. .: -_. "~'~, _.•I!Jr ~ ,ilr .i ~5" ~.a Jl 35 ".)~' 'l~' ,~ 'J,:~I :,.: ',+!' CiLui IS' aCL'.C" Or SL". ,. ~~, anC'i anal•.5:5 !SCd d.. r',~
<br />cmV.,r no li.(iUG) anCr as "f_,-~nil ,2 ;ri~ire, rn.nr"::pceif cci ir: pc -n~i. (e.g. iinif' ".. ,at, ° EuY can:~nuo'.u rraniiu~ng, "I/7"
<br />fur ace ~~/ ;i, r :'.: _'c, "l/30" .o: one r;iy ps mo.'1L•, "L90"far one day per qumter, etc.)
<br />'.. r::,~_ "S ~r„~-L• ij'~ ."'euth :n "~~,..t is ;. `.•„r~.;rrnunr" (actual sample h,'; :used du-:ng ^:rnii:c r'n;; pcned; anc as "f .~,', I:%r
<br />IZy~'4;•..rsr1." (e.g. .,.T "vr,r" fa- :.idivicui' samoi~, "~Qll~" fur 24-hour tcmpesile, •.~:%A" for con!`nunus
<br />moniWring, e1c.)
<br />Imo. CJacra violc~l;ms of p_:-mit re~uiremenls arc raponcd, ..Leh :: beef e:.pluna:ion to describe cause ant cor~ertivc serious
<br />'o be Lken, and reference each violation by date.
<br />11. If"~a dischargo" occurs daring monitoring period, ca+.~T "?Jo Gischargc" across form in place ofdata miry.
<br />12. En'.e, "A'~,:u/"1'i!L .J ;=,in_i/~I E.rs_vrr:_ GJfi~~;" ,"iiLr "Si~utur_• cj Prin_i/-J £_r>:utir~ G~_zr of .futlr,riz,:J
<br />lak_nt, ""Teldp'r..rr A'umh~r, "and "GJtz" at bottom of form.
<br />3..vlail signed Report to Office(s) by date(s) specifed in purnvt. Retain copy for your records.
<br />;. l• ore detailed iestruciions for use of this Dis_laarge id%nitoring Rr.r~ (C.Lff~ 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 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 year, or both.
<br />:EPA Form 3320-1 (Rev. 03/99)
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