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1~ ~j)c~~rk Reduction 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 I IO 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 />C'[uef, Information Foiicy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />~dashington, D~ 2046D; and to the Cffice of Information and Regulatory Affairs, Office of Management and
<br />E~udget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information aUeady
<br />preprinted.
<br />2. Enter "Per-mittee Name%Yfoilir,g RJdress (and facility name/Iocation, if different)," " Parmit Number," and "Gischarge
<br />A4rmhzr" where indicated. (A sepazate form is required for each discharge.)
<br />3. Enter dates beginning and editing "ivlonitoring Perio.l"covered by form where indicated.
<br />4. Enter each "Poran,zttr" as specified in monitoring requirements of pem,it.
<br />5. Enter "S,nnpL i.itlsar~rr::nt"data for er.ch pa,arrtctr:r under "~euntiry"and Qe,aliq'" as specified in permit. "Avzraae" is
<br />nomally arithrr,etic <<z!agc (gco-ctric avcrngc for uzaarial parzmeters) of all sample measurements for each pa ~~r,ccer
<br />obtained d,ling "l. i'.nit•,r!i,b~ Fsri•; ~'; "dlr:i;ntnu" and Lfirimunr" are vernally exlr,,me high and low measuremu4s
<br />obtainer! durinb "~lnriv.,in~ F'.,r-,_l". (A!otc io mur.~c~, ,.v with secondary trcCtm;nt requirement: ;^ta 30-day avcrugc
<br />of s:~mplc mcasucm.:nts under "Av_;aoe,"and cater maximum 7-:;~y avc,~gc oCs„mple measurcmcnLS obtained drriug
<br />man'r~oring period under ":vusimrr:;r.")
<br />G. F.mzr "P;;,au! l~yui,~ra~°,r!"inrrac', l,ara,-nc[or uad•~; "~r~~nlf,~"anc "inrllity"as s;,ecificd in rertni_
<br />7. U~e'cr "i+„ i::•." en~~- ncmber c'e.!mple ~~,~.aurc-re ~. during manito~inp, ~'crad (hit c xcced ma::ir,um (~ relay r,ir~~ nom
<br />or i-ar.y avc,age us ap,~rapriatc; pt~mi'. r quirem~nt 'ur each paameter. ! f none, c rler "t7".
<br />8. ~~t1=r "I•'r,:, 'nr. !,r •sis"1-.olt av'.,:r;: - r. r..; ;ac.u f- r :a
<br />'! • ;' 7.) s.,] ar ,C~ ~ C)' Of Sa'~'~p~1ng 2n"~ an3tvS:S used d'1~ulg
<br />nnr,'.wi,~g period) a,w zs "1'-cn7 R~;;~ir_mer."spcaiGcd in pcr:,,il. (c.t;. -n!cr ":<r-.,"fcrca~G.~~olsmonitorirg, "i/7"
<br />:ur anc dz; pu I:-a~.'~ "!/30" :or c::c %~', pc. month, .'!%40" fc: a ;~ dry per yuarLrs, etcJ
<br />S. L-n'_, tia„t L• tjE_"i;aLl rs "S_~ rr, L,__,..,,u: ,,"(sch,~l sample t}~e escrl _rnring,^anitarin~ period) acd as ", , nut!
<br />ksarir_.ne,,r," (e. g. ;?n:c "Grab" fur ;r,Lisid.:l sample, "'dH,:" for 2t-i,eur cov.posita, "~1'/A" for con'.inucus
<br />monitoring, ctc_)
<br />l O. ~ :~1CI'C Vlal d'On5 of t,Q~IL rC _!Lirem Cnl•. F,'~ iLpe*LLd, S LCI7 11r7C~ ~'C[J,ir!air[,R -0 L_SCTIbC CaUS~ i Tld COrCCC:iVC aC;10 iLti
<br />io be Laken, and reference each violation by date.
<br />11. If"r,o wsnhzrg~' oa:LCS doing monitor:ro pcroC:, c rcr "?;e G schargr" across furt~ in place ofda!a en!,y.
<br />12. En;cr "]Jau=/Ti!!e cf P.i,r_r! rl ra__„ri> r CJfi_'~, " with Si,;;r>_,:ur, rf r,:~n.;/-.! Esa_utiv~ Gam'^er oj" ~;t~l:,..,-iz:d
<br />figant, ""TekFlra;,e Nu,n~er,"and "!%ats" ul bottom of farm.
<br />13. iviail signed RepeR to Cffiee(s) by date(s) spccifcd in pemtit. Retain copy for your records.
<br />14. Nore detailad instructions For use of this Pis~lurhr ivl'mitoring RsF;rt (Tin; form may be abtained 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 resu]t 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 tLan one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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