|
~~-. L
<br />~ Paperwork Reduction Act Notice
<br />I ~ubhc reporttr" burdut for this collection of information s estimated to vary from a range of 10 hours as an
<br />, zyc pe: ,esponsc o ~ some +n uoi face ties, to x.10 hours Zs an a^erage per response for some major facilities,
<br />v~,h a ~ze~ghted av~ age 'or is ~~, a ~~! r, .nor °a~iiihe~ of 18 hours per response, iccluding time for reviewing
<br />instr,u':'or.~ ,erching zYistmy deta sources, yatheting a:.~ a~.aia:~;,;ing the data needed, and completing and
<br />~~=:iew;r,- i'',c rollrction of information. Send comments .-5 r'~~g the burden estimate ut amt other tepee: of
<br />ties eo,iection of i~ ~ ~t~: ,i~_,. nc:uding suggestions fur -• ,i c~~^ chi, h..nice- r:~ ~;~°. 'r.fo. muC'~,on Poiicy
<br />I Branch, rte.-223, CJ.S. En'r.ronn.c.u,i i'roteuion Agent}~, 401'vI Street, S~V, W ashington, DC 0:60; and to the
<br />Office of Information and Regulato,y r`.ffaia, Office of Management and Fudge!', ':/ashington, DC 20503.
<br />General Instructions
<br />L If form has been partially completed Ly preprinting, disregard instructions directed at entry of that information
<br />already preprinted.
<br />2. Enter "Pem~l:Yee Name%Mailing .-iddress (and facility name location, if ditlerent);' "Permit Number;' and
<br />"Di3rcharge Numbed' where indicated. (A separate form is required for each discha ;e.) _
<br />3. Enter dates bcg:anino a^d ending ".Monitoring Period" covered by form where indicated.
<br />1. Enter each "Paramete-" as speri','rd '~^ monitoring requirements of permit.
<br />5. Enter "S-7rnnte Measurern.m.'" da*a fn_ each pazameter under "Quantity" and "Qcro(iry" in units'specified inperntit
<br />"Average" is normally arithmetic z.rrage (geometric average for bacterial parameters) of all sample measure-
<br />ments for each parameter obtained during '7~lonitoring Period"; "Maximum' and "Min` um" are normally ex-
<br />treme high and Iuw measurements obtained during "Monitoring Period." (Note tom icipals with secondary"
<br />trc.:'mant requirement: Enter 30-day average of sample meast.rrmerrs under "Average," and enter maximufn' ,
<br />.-day average of sample measurements obtained during monitoring period under "Maximum:')
<br />6. F.nr_r "Pe.m'ut k,zuirem~nr" for each parameter under "Qunnuty" and "Qe:uliry" as specified in permit.
<br />7. Under "No Er' enter number of sample measurements during rhontyuing period that exceed maximum (and/or
<br />minimum or 7-day average as appropriate) permit requirement fof0ach parameter: If none, enter "0."
<br />3. Enter "Frequency ofAnatysis" both as "Sample Measurcmert" (actual frequency of sampling and analysis used
<br />during monitoring period) and as "Permit Requirement' specified,in permit. (e.g., Enter "Copt;' for continuous
<br />monitoring, "1/T' for one day per week, "1/30" for one day per moutfi"'°L/90" for one day per quarter, etc.)
<br />9. Enter "Sample 7}~pe" both as "Sample hfeasurement" (actual -sample hype used during monitoring period) and as
<br />"Permit Requirement," (e.g., Enter "Groh" for individual sample, "24!iC' for 24-hour composite, "N/A" for con-
<br />tinuous monitoring, etc.) ,..
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />actions taken, and reference each violarion by date.
<br />11. If "no discharge" occurs during monitoring period, enter ' .^rc 77iuha ;e" across form in place of data entry.
<br />12. Enter "Nam/'~itle of Principe; Executive Officer' with "Signature of Principal Fxecuttve Officer of Authori.~ed
<br />Agent;' "Telep;±ortU9Vumber," and "Date" at bottom of form 4 '
<br />13. Maii signed Report to Of,`ce(s) by date(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions far use of this Diseha>o~e Monitoring Report (DMR) form may be obtained from Of-
<br />fice(s) specified in permit.
<br />_ Legal Notice ~,
<br />This report is requaed by law (33 U.S.C. 1318; 40 C,F.R~12j.27). Failure to report or failure to report truthfully can -~
<br />~fesult in civil penalties not to exceed 510,000 per day of violation; Or in crimina~enalties not to exceed $25,000 per day
<br />of violation, or by imprisonment for not more than one year, or by both. ~ .
<br />
<br />EPA Form 3320-1 (Rev. 3/99) ,~~ - - --
<br />
|