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~~=~:~ ~~°work Redaction Act Notice
<br />?u'o]ic reporting burden for this collection of inforration is estimated to very fTOm a range of 10 hours as an I
<br />~, average per response for some minor facilities, to 110 hours as an 2verage per response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 hours per response, including iimc for
<br />~ rtviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />c~~mpleting and reviewing the collection of information, including suggestion for reducing this burden, to
<br />Chief, Information Policy Branch, ?M-223, U.S. Environmental Protection Agency, 401 N Street, S.1u.
<br />Vlaslvagton, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Eudget, Washington, DC 20503.
<br />general Instructions
<br />1. If form has been partially completed by preprinting, disregard insfirction duected at entry of that information already
<br />preprinted.
<br />2. Enter "Perntirtz~ Name%Lfailing A~,tress (and facility name/location, if different);' " Pzrntit Nutn6er," and "Dischmge
<br />NuntPdr" where indicated. (A sepazate form is required for each discharge.)
<br />3. Enter dates beginning and editing "Nicnilorin~ Fzric,y"covered by form where indicated
<br />4. Enter each "Pararnstar" as specified in monitoring requirements of permit.
<br />5. L-'nter "S?rnpla rf,'ucrrr_m ~trt"data for each parameter under "~natvih," and Lnra/iq~" as specified in permit. "Av_rw~s"is
<br />ae~na'l; artt%rmctic average (geometric average for bncicrial parameters) of all sarnplc measurements for each parameb_r
<br />oburin.;d during ":41•.,cP.rino F~rioJ'; ':vi_::irviun" rnd i:iiniurttnr" are no-nlally cxir;me high and low mcasur~~;lcnts
<br />o~!rincc during '^v;•.r,i! -~~i;rb F~rF; /". (Note to mur~djals w'". secaulnry treatm~rt r~L,uircmcnL' ~ntcr 30-der}' average
<br />of sarnplc rr~ra,1>remrrts Under "~i:~era;;_,"and cric: rarx murl 7-dey arcragc efs;.n:I,le rneasurcncnts obtained durng
<br />monitoring period under '7:4axiraurn.")
<br />G. !?m.r"Fe,,.:%lRt.r.:.nr~.~;"'e eachpararrcterund_-"~.r1,.!i!p"anii"~r.:li;~"as;pccifiadinper-ri!.
<br />7. L'ndc, "?.'~ Fr" enter rumbcr Ofsumple mcavrremdN ocrinU rro: -~r:;n~ ir~r~.,c' ; .a e ~c_.;:: nlu~,irlum (a.nd,'ar rr'~r-urn
<br />or 7-d.} a\'CI,~C FY Li,i,TOrrlrte) pemit rcaui ~mcnt fm ..ac's narnmerr. If n;lnr., cats "C".
<br />s. r-,nt~- °r, ~, _;~ ~• -,f,;,vha :" ccfn rs "~ .., ! • ~•..'.. ~~ : . , ." (r r.L:cl fre:,-ar.c; c" .rirr i~E and analyser tscrl during
<br />mon~~tw~i~ pcr,od) e•r^ ;a "P.•r...i. Rs.;ci:_,rav~' nncru,cd ~r, n~n~:il. (cg. iir.e:~ ":'~,nl," ~i:r cor'Sauous o.^nitorirg, "U7•'
<br />f.. n re clay p,: wer.k, "I%30" fo, enc Gay fer rruclil, '^!S'0" fur o~:e der} p:.r quark , cte.)
<br />° ~_m_ "S±n', . 7jf ." hW,': a "S_r.rFl~ ;., ... _..ren "(~:r ,.I s ~rr;~~c ;-pc uv_d cur~ag* mn~.ilor•n~ penoui and as "r' •-„i~
<br />hd./erirnn_~,;;," (e.g. ~.r:c: "Gr~l'" fcr ;nciviLu~cl Cana' "7.;/'_' fcr 2~+-'u.~r ca:rsvsire- ';.%-:" fnr con:inuc,W
<br />monitoring, etc.)
<br />1C. S,"hcrc liolatio.ls ~; permit rcqui;cmcn+. ; :, rcporic', r:ia~lt a I::ic'.:zplcna'iu r to d.:.cribc case rni conccuva actions
<br />to be ta'.cen, and reference each vioialiom by date.
<br />l 1. if "no discharge" r1CCL!r5 dl'~in~, 1ri0nltlrirlg pCrlUa, cn;~: °1~0 ~hSCi,<",rte:" L:rG55 fG1?1 In place Of data CntT}'.
<br />]2. Emcr 'SV~mJFit!. of PrinciE~l £r-,v!irt G(,'. _ `:'ith "Sion~n!re oj`P;4:_i,~ r' Cxe_utir~ l;J~'i.er rfltdh•.rizzl
<br />F,ga;u, ""Tel°plun~ Nttrtl•zr, "and "LS!z" at bottom of foil.
<br />13. P!iail signed Repari to OTce(s) by date(s) specified in permit. Rcrnin copy for your rcords.
<br />14. More detailed instructions for use of this Cis~la,;;.: rLf~mi'srino R_•F~.r! (1_'P,IR) form ma}' be obtained from Offce(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 n-pott or failure to report truthfully can result in
<br />civil penalties not 1A 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 mot more than one yeaz, or lwth.
<br />EPA Form 3320-1 (Rev. 03/99)
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