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~~~w~~~~~~~s ~~~,.b..w...,3~®n Act Notate <br />~ ?ublic reporting burden for this collection of information is estimated to vary from a range of 10 hours as zn <br />average per response for some minor facilities, to 110 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 tirne for <br />reviewing insbuctions, seazching existing data sauces, gathering and maintaining the data needed, and <br />completing and reviewing the collection of information, including suggestion for reducing this burden, to <br />Chief, Information Policy Branch, PM-223, I1.S. Envvoamental Protection Agency, 401 M Street, S.W. ~ <br />Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management 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 "Pzn;rittee ltrame/Ma(lrng Addrzss (and facility name location, if different)," " Perntit NurnEer," 3vd "Dis~•horga <br />Numl-:r" where indicated. (A separate form is required For each discharge.) <br />3. Enter dates beginning and editing '911onira•ing Peric j"covered by form where indicated. <br />4. Enter each "Pararret~r" as specified in monitoring requirements of permit. <br />5. i7.nLCT "S_~mp!z i,;t~sur~mert" date far each parmeler urdcr "irt~atih,%" and Qe~li!}" as specifie[ in pcrm'.t. "Av:raoe" is <br />nornally a,itlunetic al crags (gcomctic zvcmgc for bacterial pai~cle[ers) of III sample rneasurertents for each pa`ametcr <br />ObfamCCf dllrlRg "ivipll !frJrlrro F'a7Lrl"; "ii Lt L.Ir4i1" and nl(di•%i I/Il!" arC RCIIDa~Iy L':.. rcme nigh and lovV mea$Gitt,TEn(J <br />obtained du.u•g ".i;•,,riro~ irrh ^~ri-d". (A!ntc [o mvnicillals 1~•i711 sccc^dary ~-c^ame~~t rr~..luiremeni: L-Hier 30-day avr.zg~ <br />of sample measuements unc.cr ";,v~rs~.," and titer mar;imum 7-~, svc;~ge of r..uple nersurc:n.;n's o;;t,ineJ during <br />monitoring period under 'Sblaxirurne.") <br />G. ,.r-er "r'a•„di!R.:gvir°mzat" For cac11 parameter under "Lr~ %,i,ifJ "..r:i "~.alllir)'"as s;lcclfied m perms <br />7. UrdCl "A'V i:X" enter ~umi:Cf O'samplc m._S n~C.rC li LL'fing ~~iGN~Ui~no' iL" Cd ttl: i LKCSed mal.im LLm (21di0* rnl ni rupm <br />or i-day a~ eraoe as appropriate) permit rcquire•rcnt fur cash parametc-. i f Hove, ento "0" <br />'~. =ntc- "Fr_;r~r~• •j ~'n%lys/s"hold as "SJ,:~~ L• ;~; ~-~~:~~ -,,... " (~ alai f u:;ue~~cj of sa`lp~ing a lri anal,~ss aLxi during <br />,nanitoring ~criod) a,1G as "1'~;„ri( 2.uri,~,.r~n,"spc~ iG.c in pc..n'L (c.g. i:r~~~ ,:•.l r,"'arcovti~uo-s n:uviluricg. "//7" <br />fur one day pc; v,re'.c, "1/30"`v: one day per moat, "//9G"for uvs day pa quarts:, c:c.) <br />9. ~:I~cr "Sl,r~l~ 7;; .:" both :rs "S_'.at:/e ;..s_v•.~_,a~;: "(.::heal r:.mn:c ,ylx'csrtl during ~.-nniWrngpc-iud) and as "Pdrn7ii <br />lt'./ni;-,;;,, _5;;," (s.g. '=n:er "G;r>h" for iadiv~ducl sumpl,;, "Zd1/~" for 2~-hot~•~ ccmpositc, '71'/!" Cor continua us <br />monitormg, etc.) <br />1~. ~'f1C11' ~rialr.tions of permit requircmcnts arc «I:oned, ctzCh : O~i~C::plCnlll~n :0 CL'".:~ ibe C£USe and CO RCCi1VL' i.L:i%0 n5 <br />to l:a taken, and reference each violation by data. <br />11. If"no discharge" occurs during , lonitori ng perior:, c Iles "ids l;acl:: ga" acrusa ion- in place of rain entry. <br />12. Cntcr "ASzmJTiN: u~'FrirrciFal !s.:,ulivs G~-•." saif4 "Si,',-n.%:r.'r• jFrin_i/~! Er~~~r~ir.~ OJ7~s.- of s'trra~..'iz_l <br />Agrnr, ""Tel.:plr;n~ iJranhs,:"and "Cats" at boaum of form. <br />13. ~•Iail signed Repcrt to OiLce(s) by riate(s) spocifiL.u ul pcnnii. Retain copy fur your rocu:ds. <br />!~. iviore detailed instructions for use of this Gisc;urge Monitai,rd .'i_/•~rT (Dn-.7~ fora may be obtained 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 cav 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 year, or both. <br />EPA Form 3320-1 (Rev. 03/99) <br />