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~'~.~~r~~rl~ ~~~.:~~;~~~. pct Notice
<br />Puhlic reporting burden for this ccllectio^ of infotlrtation is estimated to vary from a range of 10 he;;rs as an
<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 1 S hours per response, including time for
<br />reviewing instructions, seazching 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 />Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />Washington, D^ 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />~e~~eral Instructions
<br />1. If form has been partially completed by preprinting, disregard instruction directed at entry of that information aUeady
<br />preprinted.
<br />2. Enter "Penrrirtae Name/Mailing Address (and facility namellocation, if different)," " Pznnit Number," and "Gischarge
<br />Num' 'r" where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dates beginning and editing "Monitoring Pzricd"covered by form where indicated.
<br />4. Enter each "{'.!1'lnrJt_'r° as specified in monitoring requirements of permit.
<br />5. Enter "S~rnpL .V •~sra-ernent" da4 for each parameter under "r~;uvrrih~" and Qualir••" as specified in permit. "Arer-rez" is
<br />rc ;-:rally ar't`;nrtic rverage (geonettie ar_r. ge fnr hactericl poramulers) ofall sample :>,easurements fnr each pa~meter
<br />obtvi-ler: during "tF '%%ori,rg f.r%;d'; ",~-1 ~.t i,nuxt" and d(i,r%onu,;" are nominally carmc high and law m.:asurememh.
<br />obT:.i~cd dui~g ',.'.nir;,~i~e Parr,_l". (T`.'ote 'o r'unicirals wi?r secondary Ceatmenl r.-uircmert: °nter 30-dap eve age
<br />o: sanp~c mccst;cmc^.ts under "/,v"~•,e,"~-d enter mucinun• 7-d^.y averege ofsuTnle men"swe,ner[s ohlained c'ori~:g
<br />mcnifar:ng period under "ivlaxirrun.")
<br />5. ~.r!',.],:i!R:.Jvira,az;rt"`oreachparamr.~erunur"_nr~,;r;r~r"rnd."w,n/%y"255~-ClfiodlnpanTit.
<br />7. J:~d_r "P.'~. l:." ur_r nurnL'er ofsamr)c ~~~e:::~remen' doing ~-.e-'fining pe~mr' tl- ~t c .r_e3 ma~-;muri (and/or mini~Tum
<br />or 7 dry a~~:r. ~c rs : !; ~ronnatc) ,rermit rc:lu~~cmcnT for rich prrdmctrr. ;f Hong c.n*cr "G".
<br />8. ?.~!.r ',ter: v ~.:~ •y".faalyccis" I]ati, as "S_~.:; ;'_ ;.: ::, ._,::,rr" (ucwrl G--; ru_i,c; of snmp;in~ rrd am~l;sis rued coin;;
<br />-rani nii~.a rr.:oi1 rnc; : "P~,-,.~it 2gci;rrn v+r",,,uriGrd in pcr~.i!. (c.g. ~-TCr '_~.nl." "cr ccnt;mlmus munitcrirg, "V7"
<br />for we day ;rc- ~ti: !4 "1/30" for ore ray per march, "//90"for nnc dsy per quaver. Cc)
<br />9. °.-'._ "S~n;r!; T ~r_ ':otn as "Sa;nrh: ,,....; ca„_, !" ( ctu: { ;; mp~c type a~_S c!ur;nq :r.nnft;rs„ ,.erir,d) and rs "Tsnn;,
<br />R:y.~J-rni•ar" (c.g. Ln[cr "Gra1~" for irdi-,ddcul r4-1p!e "14/l~" `Cr 24-~'JCl' l';1'npO51tC, "~-7A" roc conEneous
<br />monitoring, eTc.)
<br />] 0. !'.^+~rc violrtions cf permit requir,•rcnts ar; :eporte~, attach a'r fief explanation to d~scribc cause and cmccctive actions
<br />to ~c ta!see, and reference each violation by date.
<br />! i. If"nor dtschargc" occurs dn,icg :nmitairg period, ent, r "1\'o Bi~ch~srge" across form in plrcc of data entry.
<br />12. Corer "N:n;r.~/Titl~ cf Frirreir,ri Ez_~ulir' G(j`.a, 'with "Sigrunrr.r cf Frincir~.' Fi~.v/iv. GJ>i__r rf Ar•rh•rn'rel
<br />Agora, ""Tekphons itrmnF.ar,"and `not ~" at bottom of form.
<br />13. ''dai] signed Report to C~ce(s) by date(s) specified 'n permit. Retain copy for your records.
<br />14. Vlore detailed instructions for use of this Gis_hlraa Monito;-in;; I<e/-;rl (L,".rlRf fora may be obtainer from Cfficc(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is requvcd by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully 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 day of violation,
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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