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'='~~~:~~rl~ Red~xction Act Notice
<br />1. u. .
<br />.~
<br />Puhlic reporting bwden for this collection of infonmation is estimated to vary from a range of 10 hows as an
<br />arrerage per response for some minor facilities, to 110 hows as an average per response For some major I
<br />facilities, with a weighted average for major and mii-tor facilities of l8 hours per response, inc'uding time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the dsta needed, and I
<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 />V4'ashington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />I. If farm has been partially completed by preprinting, disregazd instruction directed at entry of that information aUeady
<br />preprinted.
<br />2. Eoter "Pennittee Namehvhiling Address (and facility name location, if different)," " Pzrmit Numbsr," and "Disshargz
<br />Nuntbzr" where indicated. (A separate form is required for each discharge.)
<br />3. Enier dates beginning and editing "monitoring Pari•,d"covered by forth where indicated.
<br />4. Later each "Paramrhr" ae specified in monitoring requirements of permit.
<br />5. Enter "S~nplz i:a.~~sureu:::rt" da4. for each parameter under "~`runti,y" and ;.vufit~ "as specified in permit. "Arrasz" is
<br />normally arithmetic avcrge (geometric ::vcrage for bactcrial.pammetcrsl cf all sanrple measurements for each parameter
<br />obu,inzd during ",Ll,nir-,ri:tg Per%;J'; "14~liurarr~" ~'td bTinim~n,r" arc nn:m.ll;~ carrmc high a'td :o~~ mcacu-.:;nents
<br />ohttined dui ~g "t; .,:i.'.. i,to T~ri•.d". (1JoCe to .nur;cio.~ls v,~"~ secondary trcahnenf .r: uircmcnt: rater 30-day avrrge
<br />o` sample rncaswcmc-rs nnter ",4ver1„" acd cmcr -rzxirnum. 7-day aver,~ge a` s. nf:!c ,rcasurc ^cn's obtains: dcrirg
<br />monitoring period under ",ti;~rirmrr.")
<br />J. ;;n::,' "/'d ill: fi'.l:''.dN;_'.:t" r'Ji eaCb paraTnCiCr L'IdCr "Qtr~.•lih~"2^d "~u~lity"2s spictfie~ to permit.
<br />7. Under "~?'. ?r" cucr r.umbe- of sample rncacmemen' ur r;ng ~no~ „~-in~ , a rod tl ~t e:.eecd mc:.inum (std/or mini 7um
<br />r: 7ttt~~ uvcrg_ ^s ~opronriatc) nc*mil rcyui rmcnt for each pamntet,r. )f ^o^.q enter "D".
<br />'. r. ~ "; ~rr, _, .~, •j 'n~l;•.c:. 'Loth cs "5_~,,,f /. ,ld- ~sr, _,. _,rr" (rctur f;c;ucrt;r of ssm i ing and analysis tscd duti~,g
<br />monitorng fu;od) rr-1 as ,',~~r,~,::ir R::;ui.:n. ,nr" specifCd lr. rc~~rJ: i1.~. !J',!Lr "..•„rt. " ~cr cnrlivuous n!oniicr;cg. "//7"
<br />for one day pc-wee'.:, "1/j0" fur one day per month, "I/97"for one day per yuar'.c ,etc.)
<br />4. ,ter "S.•,;;,-!_ Tit _"bat} es ".S.n,rTt ~ ,..__... „r..',,~' (ach~l san;plc ;vn;; nscd c'wtitg mo~i!oring pc-io;; and as',~~,:.71'
<br />R.:_/r!ir:,n~et,'' (e~. '-;nlcr "~;-,~F" far u~di~.~dual scnn'e, "24~1~ 'cr 7~~ie.~r tom;^,osit~, "rV~:" for co~tinucas
<br />monitoring, etc.)
<br />10. C.nter, violalic,ns of permit requiremen±s aro reported; atiach a b-icf explanation to describe cause ant eotTxtive actions
<br />to be fatten, and reference each violation by dare.
<br />l 1, t; "no discitarg~' occu-s daring monitoring period, enter "No Dicchame" tcross fo: m ;n rla~:. o~ data entry.
<br />17_. F_n:cr "NamJTill~ :; I7"iL.'r,,l s~.;: _i,tn„ ;~f:_r" rvi[h "Si;;n~n.~.r cf l7is;,i~,' hx.~vtivz Uffi::er cf Arthr,.izeJ
<br />~:gant, ""Talaphon ~ F'wnF~r, "and 'T.rtz" at bottom of form.
<br />13. A/,cil signed Repor~ to Cfficc(s) by datc(s} specified ~n pcnnit. Attain copy for your records.
<br />14. More detailed instructions for use of this Lic,aurbs ,14~.utroring R,1-ort (C1lrR) form may be obtained from C~7icc(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 yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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