|
~a~Wrwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary froim a range of 10 hears as an
<br />average per response for some minor facilities, to 110 rows as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 rows per response, inc]uding 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 bwdca, to
<br />Chief, 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 Mana.gcment and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Pennittee Name/Mailing Address (and facility name/location, if different)," " Pzrmit r~'umber," and "Dis=hargz
<br />Numbzr" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing "Mariroring Pzri.J" wvercd by form where indicated.
<br />4. Enter each "Porar~reter" as specified in monitoring requirements of permit.
<br />5. Enter "Samp/e M-:on?r~m_nr" data fnc each pararncter under ' ~o~nfi7," and _:'ualih~" as specified in pemit. ".Ir •.,iti:" is
<br />or~nally arithmetic zvemge (geometric average for bacten~ l parameters) of all sample mcasurcme~tls :or each paramc+. r
<br />obtained during ".'vL,vtsri,rg ,^.:ri.l"{ ",1/..tinn~,a" and lliui.~r..ua" arc nonnsL'y _,.~..:~ic ~iigl- end 'o.r mcasurneah.
<br />obtained during "Iri~.nih ; iie F,•ri . ~". (Tote :o mwn`cinals cri'~~ second,:r} rrcntmc:~' - : u rdme lt: '~Ycr 30-day ;.te-rat
<br />of sample meauremcnts unc'c- "Av~;~~ •a,"and eater mr.~mum 7-dry avciagc o~"s :m;,le mesaem~n[c obl<in.. i:urirg
<br />moo itoring period under "hluimroa.") J
<br />u. i:nl_r "P~.;ri: 2~!ui, rrazat"`or cash paramcLr and.- "~rr,;tily" a :d "~rrzlir)~"as specified in peon' .
<br />7. Under "id', L.r" enter rumher of sample rnpc,wcm,,' r',~rir~ moo nine -_.~od f-. t r:ur_s T,_.imurc (.!:L-cr irra',:,ur•
<br />cr 7-day avc Wig;, as : pproprictr) ~c*mit nq :'re n_.:i for each prr•m~L'- J~f no -,c, toter "0".
<br />C. C~~I: "!•fr_;r:r,r_;~ q`. `,ul;~s;s" bath a_s "P .. ~-!_ d4_, ~ -, _,,.. ,~~" (actua ;req.c~,c; r." srmi.:ing .. .:d anrl.,ris used c'crin~
<br />monitorng nc,;od) c.na as "P'.-zip R::;r:L•_n:rr,"specified .n pcrn,i'. (cg.l=r.n: .'..• nl,"fur cat'r-uc.~s monitnriro, "//7"
<br />fcr one day per r; ce!:, "//30" fur cnc day pa iront4, "//90"for one day per yuar~e , c'~:.)
<br />S. "n!er ".~.:nrFle T;f ~" cot''. a "S.r..yts Aie~svru„i -,rr" (acthal say: plc Y;^.c ^szd du-irg n:o-;iicrins ,crin~3; arr'. es "f.•;nrir
<br />„~
<br />R~avirs.rr~;:l," (c.g. L-ntcr .,,vP" for individual srm-!_, "~;U~" fir 24-'~:.._~ r.irposllc "~~,r/,!" far cmitinccu:~.
<br />monitoring, etc.) -
<br />10. C,"oc ;. r.oletions of permit requiremcn's arc re o"c~, aCaeh a brief e::nlcnstion M d-~cr ie cause and corrective acr~no:
<br />to be tahcn, aad reference each violation by date.
<br />I1. If"no discharge" occurs during monitoring pcr;nd er,tcr "No Discharge" scross Cone ;n plzec nfd~ta c;:r~.
<br />]2. Enter "i~hrr~/Ti!l_ cf Fri,rei/-~! E;:~=uri:.: Ofj': ~r" with "Si;;vR~rs of ?'r%n :i; ~t r~~ +rtiv_ Oj~~_•,- ~,f i~ur,'ror:' _•J
<br />Ag'nt, ""Tz(zplr.nz NunrFz;,"and "Daly"at bottom of farm.
<br />I3. Mail signed P,eport to Office(s) by date(s) specified ~n permit. Retain copy for your m rn't~s.
<br />14. More detailed instructions for use of this Dis~hn~z Mnnirorirrg Rzpsrt (I;/v1R) fo~-n may be obiaincd :ro:a Oflicc(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 truth Cully 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 coy of violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
<br />
|